Adli tıp uygulamalarında yara yaşı ve canlılık bulgularının değerlendirilmesi

Yaraların değerlendirilmesi Adli tıp pratiğinin en önemli uygulama alanlarındandır. Adli tıp uygulamalarında otopsi sırasında saptanan bir yaranın ölümden önce mi, yoksa ölümden sonra mı meydana geldiğini (canlılık) ve ölümden önce ise, ölümden ne kadar önce meydana gelmiş olduğunu (yara yaşı) tespit etmek son derece önemlidir. Yaranın özelliklerini doğru ve objektif bir şekilde tanımlamak, yara canlılığını ve yaşını saptayabilmek adli sürecin doğru işleyebilmesi için gereklidir. Bu nedenlerle canlılık ve yara yaşı değerlendirmeleri adli tıp alanındaki araştırmaların en ilgi çeken konularındandır. Yara iyileşmesi basit ancak iyi organize olmuş biolojik bir süreçtir. İnflamasyon, proliferasyon ve maturasyon olmak üzere birbirini takip eden üç süreçten oluşur. Çok sayıda biolojik madde yara iyileşme sürecinde rol almaktadır; bu kısa ve basit yara iyileşme süreci adli tıpta yara yaşı ve yara canlılığının saptanmasında kullanılabilir. Son yıllarda immünhistokimyanın ve kimyasal tekniklerin gelişmesiyle bu alan hızla ilerlemiştir. Günümüzde yara yaşı ve canlılık soruları üzerinde çalışmak için temel olarak immünohistokimyasal yöntemler, biyokimyasal yöntemler ve moleküler biyolojik teknikler kullanılmaktadır. Çalışmada yara yaşı ve canlılık değerlendirmesinin adli tıp uygulamalarındaki yeri, yara yaşı ve canlılık belirlenmesinde kullanılan yöntemler, bu alandaki gelişmeler ve uygulamadaki sorunlar tartışılmıştır.

Evaluation of vitality and wound age in forensic medicine practice

Wound examination is the most important application areas in the practice of forensic medicine. It can be an important matter in forensic medical investigations to determine whether a wound found at autopsy was inflicted before or after death and, if inflicted ante-mortem, how long before death it was sustained. It is essential to define characteristics of the wounds, and it is always necessary to determine wound vitality or wound age to correctly evaluate the progress of the judicial process. Because of these reasons wound age determination has been one of the most popular themes in forensic research. Wound healing is a primitive but well orchestrated biological phenomena consisting of three sequential phases, inflammation, proliferation, and maturation. Many biological substances are involved in the process of wound repair,and this short and simplified overview of wound healing can be adopted to determine wound vitality or wound age in forensic medicine. With the development of immunohistochemistry and chemical analyses, the scientific field of wound age determination has advanced progressively during recent years. Nowadays, immunohistochemistry, biochemical tests and molecular biological techniques are mainly used studying questions of vitality and wound age.In this study, evaluation of the value of wound vitality and wound age in forensic medicine practice, the methods used to determine wound vitality and wound age, developments in this field and the issues of forensic practice were discussed.

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