Soft ligature / padding
The use of bed sheets or similar is often found where the suicide has no access to a classic ligature (e.g. suicide in a prison cell). There have however also been cases where a soft, broad ligature is intentionally used or padding is laid between the ligature and the neck (hand towel, roll collar), presumably to avoid the pain of compression on the throat. The effect of such measures often defeats the intended objective: unconsciousness and death are achieved the more effectively the blood supply to brain is interrupted. The broader the ligature, the force needed to achieve the compression effect must be greater than that from a thin ligature. In an atypical hanging situation it can therefore happen that, due to incomplete compression of the arteries, the suffocation process may be slower. Intensive congestion signs could be the result. The ligature marks are often not clearly recognizable as such. They remain more often only as blanching of the skin or in the form of unspecific desiccation.
Belt and hand towel
N.B! Tight fitting clothing, skin folds or items pressing against the body can leave marks similar to those from a ligature.