Turkiye Klinikleri Journal of Forensic Medicine and Forensic Sciences

.: ORIGINAL RESEARCH
Yüzde Sabit İz Değerlendirmelerini Standardize Edebilecek Kriterlerin Belirlenmesine Yönelik Ön Çalışma: Kesitsel Bir Araştırma
Preliminary Study to Determine the Criteria That Can Standardize the Evaluation of Permanent Facial Scars: A Cross-Sectional Research
Eda KÜRKÇÜ ERDEMa, M. Hakan ÖZDEMİRb
aŞişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Adli Tıp Birimi, İstanbul, Türkiye
bDokuz Eylül Üniversitesi Tıp Fakültesi, Adli Tıp ABD, İzmir, Türkiye
Turkiye Klinikleri J Foren Sci Leg Med. 2023;20(3):182-91
doi: 10.5336/forensic.2023-97335
Article Language: TR
Full Text
ÖZET
 Amaç: Yüzde ilk bakışta belirgin bir şekilde dikkat çeken iz, iletişimde birçok biyopsikososyal probleme yol açabilmektedir. Yüzde sabit iz (YSİ) pozitifliği, Türk Ceza Kanunu'nda cezada artırımı gerektirmektedir. YSİ değerlendirmelerinin yeniden düzenlenmesi sonucu farklı kararların olması, ceza davalarında kabul edilemez. Bu çalışmada yargılamadaki hak kayıplarını minimalize etmek için YSİ değerlendirmelerinde objektif parametreleri belirleyecek ve değerlendirmeleri standardize edecek nesnel kriterlerin oluşturulması hedeflenmektedir. Gereç ve Yöntemler: Çalışma bir yıllık sürede ana bilim dalımıza gönderilmiş 43 olguda yapıldı. Yüz bölgesindeki yara izlerinin özellikleri, farklı muayene koşullarında (yapay/gün ışığı ve mesafe) 2 hekim tarafından muayene edilip, fotoğraflandı. Bilgiler, veri kayıt formlarına işlendi. Elde edilen verilerin SPSS 24.0 programında analizleri yapıldı. Bulgular: Kırk üç olguda 63 lezyon saptandı. Olguların yaş ortalaması 36,65±13,96 olarak tespit edildi. Uzunluğu 2 cm'nin üzerindeki yara izleri istatistiksel olarak anlamlı şekilde YSİ (+) değerlendirildi. Mimik hareketleriyle belirginleşen lezyonlara, belirginleşmeyenlere göre daha fazla YSİ (+) kararı verildi. Gün ışığı/yapay ışık ve 1-2 m koşullarında, 1 ve 2. hekim tarafından yapılan değerlendirmelerde; lezyonların tanımları ve olguların ten renklerine göre tutarlılık uyumları iyi-çok iyi düzeyde saptanırken, lokalizasyon ve mimik hareketlerine göre YSİ pozitif/negatif değerlendirmesinde ise orta ve üzeri düzeyde uyum saptandı. Sonuç: YSİ değerlendirmelerinde mesafe, ışık kaynağı ve değerlendiren hekimler açısından objektif kriterlerin sağlanmasının gerekliliği kaçınılmaz olmakla birlikte, bu şartların sağlanması oldukça güç görülmektedir. YSİ değerlendirmelerinde multipl faktörlerin etkisini ve hak kayıplarını minimalize etmek amacıyla, günümüzde hızlı gelişimin/değişimin yaşandığı robotik/yapay zekâ uygulamalarından adli bilimler alanında da faydalanılması gerektiği düşüncesindeyiz.

Anahtar Kelimeler: Yüzde sabit iz; medikolegal değerlendirme
ABSTRACT
 Objective: The mark on the face, which is clearly noticeable at first glance, can cause many biopsychosocial problems in communication. Permanent facial scar (PFS) positivity requires increasing the Turkish Penal Code penalty. Having many decisions with re-evaluation of PFS, it is unacceptable in criminal cases. This study aims to identify objectivity parameters of PFS and to establish objective criteria for standardizing these evaluations in order to minimize loss of rights in the trial. Material and Methods: The study was conducted on 43 cases referred to our department by judicial authorities for PFS evaluations in one year. The features of the facial scars were examined and photographed by two physicians under different examination conditions (artificial light/daylight and distance). The information was processed into data registration forms. The obtained data were analyzed in SPSS 24.0 program. Results: Sixty-three lesions were detected in 43 cases. The average age of the cases was 36.65±13.96. Scars with the length more than two cm statistically were significantly evaluated as the PFS (+). PFS (+) decision was made more often for lesions that became evident with mimic movements compared to those that did not become evident. In evaluations of first and second physicians, under daylight/artificial light, at a distance of 1-2 meters; the consistency scores were good-very good levels according to the skin color and to the definitions of the lesions, moderate and above level of consistency was identified for PFS positivity/negativity evaluation according to localization of lesions and mimic movements. Conclusion: In PFS evaluations, it is inevitable to provide objective criteria in terms of distance, light source and evaluating physicians; however, these conditions seem very difficult to be providen. We think that robotic/artificial intelligence applications, where rapid development/changing is experienced today, should be used in the field of forensic sciences in minimizing the effect of multiple factors and loss of rights in PFS evaluations.

Keywords: Permanent facial scar; medicolegal evaluation
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