Kelly et al developed a scale for objectively describing injuries after sexual intercourse. The authors are from Alameda County Medical Center and Samuel Merritt University in Oakland, California.
Patient selection: female after sexual intercourse
Examination: genital injury
Parameters:
(1) swelling
(2) color change/discoloration (erythema to purple)
(3) tissue break (tear to abrasion)
(4) hymen and introitus
(5) toluidine blue dye uptake
Parameter |
Finding |
Points |
swelling |
none |
0 |
|
mild |
1 |
|
significant |
2 |
color change |
none |
0 |
|
pink to slight reddening |
1 |
|
significant redness |
2 |
|
purple |
3 |
tissue break |
none |
0 |
|
superficial |
1 |
|
mild (epidermis) |
2 |
|
moderate (into dermis) |
3 |
|
severe (into subcutaneous tissue or deeper) |
4 |
hymen and introitus |
normal |
0 |
|
incomplete tear |
2 |
|
complete transection |
3 |
|
complete transection AND disruption into introitus |
4 |
toluidine blue uptake |
none |
0 |
|
flat or punctate uptake |
1 |
|
specific uptake |
2 |
total GISS =
= SUM(points for all 5 parameters)
Interpretation:
• There are 3 results for the GISS - GISS score, class and injury type.
• minimum GISS: 0
• maximum GISS: 15
• If the maximum point assigned is 0 or 1, then termed Class A. Else Class B.
• The various pattern of injury is divided into 5 types of injury.
Injury Type |
Features |
1 |
all findings negative or normal (GISS 0) |
2 |
all findings minor (at least one finding scored 1 point, none higher); MAX(points) = 1 |
3 |
mild to moderate injury; MAX(points) = 2 |
4 |
moderate tissue break and/or complete transection of hymen |
5 |
severe tissue break and/or injury to hymen and introitus; MAX(points) = 4 |
Specialty: Clinical Laboratory, Emergency Medicine, Obstetrics & Gynecology, Pedatrics
ICD-10: ,