There seems to be some smearing on the upper wound (which does not quite make sense.)
But there are smearmarks on Sheila´s nightgown, clearly made by fingers, most likely her fingers. There are streams of dried blood on her lower arm, consistant with her having held her arm/hand up to her neck. (I have seen this happen in front of my eyes recently. My husband had a sudden nosebleed, and he quickly moved his hand up to his face. Blood ran down his forearm, and I was amazed to see that the pattern was pretty much exactly like the streams you see on Sheila´s arm. The blood dried very quickly, and it "stopped" on the arm as you see in the photo.)
There is also the large, triangular bloodstain in Sheila´s armpit-area, which indicates that she had her hand up. How did it get there if she hadn´t - and how did the fingermark-smear on the nightgown get there - and the streams of blood on her lower arm? How?