Factors associated with challenges in skin wound length and depth prediction of physicians in forensic cases

Yıl 2023, Cilt: 6 Sayı: 3, 586 - 591, 31.05.2023

Seval Komut , Burak Gümüş , Burcu Doğan , Oğuz Kağan Uludağ , Salih Yağcı , Mert Barındık , Ali Kemal Erenler

https://doi.org/10.32322/jhsm.1235569

Öz

Aim: We aimed to display factors associated with error rates in identifying skin lesions with subjective methods and determine potential effectiveness of objective and metric measurements on judicial processes which may result in unwanted social and legal outcomes and raise the awareness of physicians.
Material and Method: We made an incision on a piece of sponge with a lencet in order to model a skin lesion. The length and depth of the lesion was measured by compass device. Then, a face to face interview was planned with the physicians working in the hospital and they were asked to estimate the length and depth of the lesion. Estimations of the physicians were recorded.
Results: Total of 146 physicians were involved into the study. Of these, 41.8% (n=61) were female and 58.2% (n=85) were male. Mean age of the physicians was 33.46±7.94 (24-61) years. Of the physicians, 7.5% (n=11) were a member of basic medical sciences, 26% (n=38) were a member of surgical medical sciences and 21.9% (n=32) were practitioner physician. When titles of the physicians were investigated, it was found that 21.9% (n=32) were practitioners, 34.9% (n=51) were residents, 34.9% (n=51) were specialists, 8.2% (n=12) were lecturers. The rate of the participants who estimated the incision more than 8 cm was higher than those who estimated less than 8 cm. Standart deviation of the depth estimation was 1.35 cm. Thirty-nine (26.7%) participants made an exact estimation of the depth of the incision.
Conclusion: The measurement accuracy without a device is not associated with experience and errors of both inexperienced physicians and experienced physicians of any grade do similar mistakes during judicial report preparation process. These high error levels reveal that use of devices may avoid errors of physicians at any grade and protect physicians from possible judicial challenges.

Anahtar Kelimeler

Forensic, skin lesions, measurement

Kaynakça

• James JP, Crane J, and Hinchliffe JA. Clinical Forensic Medicine: A Physician’s Guide, 2nd Edition Edited by Stark M.M.: Totowa, NJ.; 2009
• Beyazta Fy. Adli rapor konusunda hekim sorumluluğu. Anadolu Psikiyatri Derg 2000; 1: 231-4.
• Serinken M, Türkçüer İ, Acar K, Özen M. Acil servis hekimleri tarafından düzenlenen adli raporların eksiklik ve yanlışlıklar yönünden değerlendirilmesi. Ulus Travma Acil Cerrahi Derg 2011; 17: 23-8.
• Çetin, Z. E., Teyin, A., Birben, B., Çetin, B., Şahiner, G. G., Hamamci, M. Acil serviste düzenlenen adli raporlarin değerlendirilmesi. Bozok Tıp Derg 2018; 8,34-40.
• Yavuz Y, Yürümez Y, Küçüker H, Demirel R, İkizceli İ, Akdur O. Acil tıp hekimlerinin adli rapor düzenlenmesi ile ilgili bilgi, tutum ve davranışlarının değerlendirilmesi. Tr J Emerg Med 2004; 4, 64-7.
• Tümer AR, Keten A, Karacaoğlu E. Adli olgu bildirimi ve adli raporlar. Hacettepe Tıp Derg 2010; 41: 128-34.
• Zeyfeoğlu Y, Uluçay T, Yavuz MS, Aşırdizer M. Adli tıbbi uygulamalarda hatalı tanımlama, yanlış karar: olgu sunumu. Ulus Travma Acil Cerrahi Derg 2010; 16: 185-8.
• Korkmaz T, Kahramansoy N, Erkol Z, Sarıçil F, Kılıç A. Acil servise başvuran adli olguların ve düzenlenen adli raporların değerlendirilmesi. Medical Bulletin of Haseki/Haseki Tip Bulteni 2012; 50: 14-20.
• Karbeyaz K, Gündüz T, Akkaya H, Urazel B, Kökçüoğlu MA. Adli raporlara dikkat; Eskişehir deneyimi. Sted/Sürekli Tıp Eğitimi Derg 2012; 21: 292-6.
• Tuğcu H, Toygar M, Can İÖ, Safalı M. Hekimin adli ve tıbbi rapor hazırlama sorumluluğu. TSK Koruyucu Hekimlik Bülteni 2006; 5: 466-75.
• Tüzün B, Elmas İ, Akkay E. Adli rapor düzenleme zorunluluğuna hekimlerin yaklaşımı anket çalışması. Adli Tıp Bülteni 1998; 3: 27-31.
• Aktaş EÖ, Kaya A. Yaralama suçlarının adli tıbbi değerlendirilmesinde kullanılan kılavuza bakış. Adli Tıp Bülteni 2017; 22: 45-53.
• Kafadar H. Yaşamsal tehlikeye maruz kalan 78 olgunun tartişilmasi. Mustafa Kemal Üniversitesi Tıp Derg 4: 14-8.
• Jørgensen LB, Sørensen JA, Jemec GB, Yderstræde KB. Methods to assess area and volume of wounds–a systematic review. Int Wound J 2016; 13: 540-53.
• Khoo R, Jansen S. The evolving field of wound measurement techniques: a literature review. wounds: a compendium of clinical research and practice 2016; 28: 175-81.
• Lee L. How to measure wounds. Wound fırst aıd. First aid and emergency health care. Erişim adresi: https: //www.wikihow.com/measure-wounds. Erişim tarihi: 19.12.2022
• Flanagan M. Improving accuracy of wound measurement in clinical practice. Ostomy/wound management 2003; 49: 28-40.
• Yemenici S, Sayhan MB, Ömer S, Yilmaz A. Acil serviste düzenlenen adli raporların değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Derg 2017; 14: 179-86.
• Türk Ceza Kanunu’nda Tanımlanan Yaralama Suçlarının Adli Tıp Açısından Değerlendirilmesi Rehberi. Adli Tıp Uzmanları Derneği, Adli Tıp Kurumu Başkanlığı, Adli Tıp Derneği. Erişim Adresi: https: //www.atk.gov.tr/tckyaralama24-06-19.pdf. Erişim Tarihi: 01.10.2022.
• Turla A, Aydin B, Sataloğlu N. Mistakes and omissions in judicial reports prepared in emergency services. Ulusal Travma ve Acil Cerrahi Dergisi= Turkish Journal of Trauma & Emergency Surgery TJTES 2009; 15: 180-4.
• Peterson, N, Stevenson, H, Sahni, V. Size matters: how accurate is clinical estimation of traumatic wound size?. Injury, 2014; 45: 232-236.
• Demirci Ş, Günaydın G, Doğan H, et al. Adli rapor düzenlemede uygulamalı eğitimin önemi. Adli Tıp Derg 2007; 21: 10-4