Köpek ýsýrýklarýna baðlý yaralanmalarýn týbbi ve hukuki yönleriyle deðerlendirilmesi: Türkiye çalýþmasý

yaralanmalar, adli ve týbbi boyutuyla tüm dünyada ve ülkemizde önemli bir halk saðlýðý sorunudur. Çalýþmamýzda; adli rapor düzenlemesi için kuru-mumuza baþvuran hastalarýn adli ve týbbi yönden deðerlendirilmeleri yapýlarak çözüm önerileri sunulmasý amaçlandý.
GEREÇ VE YÖNTEM: Ýstanbul Adli Týp Kurumu Baþkanlýðý’na 2015-2021 yýllarý arasýnda adli rapor düzenlemesi için yargý mercileri tarafýndan gönderilen 149 olgu retrospektif olarak incelendi. Çalýþmaya dahil edilen olgular hakkýnda bilgiler arþiv kayýtlarýmýzdan ve Ulusal Yargý Aðý Projesi (UYAP) sisteminden elde edildi. Veriler Excel 2016 for Microsoft programýna kaydedildi ve verilerin biyoistatistiksel deðerlendirmesi SPSS Programý Sürüm 25 ile analiz edildi.
BULGULAR: Olgularýn %57’si erkek ve ortalama yaþ 33.7 idi. Olaylarýn %56.4’ü þehir merkezinde, %30.9’u yaz aylarýnda, %65.8’i sahipsiz (sokak) köpekler tarafýndan meydana geldi. Lezyonlarýn %54.4'ünde kas dokusu içermeyen yüzeysel yaralanmalar, %22.8’inde derin doku defektleriflep yaralanmalarý, %4.7’sinde damarsinir yaralanmalarý, %16.1’inde kemik kýrýklarý ve %2’sinde iç organ yaralanmalarý bulundu. Olgularýn %37.5’ine cerrahi iþlem yapýldý. Olgularýn %22.1’inde ciddi sekel (maluliyet), %16.7’sinde yüzde sabit (kalýcý) iz ve psikiyatrik deðerlendirilmesi yapýlan (%48.9; n=89) olgularýn %57.5’inde post travmatik stres bozukluðu (PTSB) tespit edildi
SONUÇ: Köpek saldýrýlarýna baðlý yaralanmalar sonucunda kiþilerde gerek psikiolojik (PTSB gibi) gerekse fiziksel (yüzde kalýcý iz, maluliyet gibi) olarak ciddi sekeller ortaya çýkmaktadýr. Tüm köpek saldýrýsý maðdurlarýnýn multidisipliner bir yaklaþýmla fiziksel, sosyal, psikolojik ve kognitif açýdan rehabilitasyon programlarýna dahil edilmelidir. Yapýlacak uluslararasý sözleþmeler ve hukuksal düzenlemeleri ile hem kiþilerin maddi ve manevi zararlarý giderilmeli hem de baþta sahipsiz köpekler olmak üzere tüm hayvanlarýn korunmasý, bakým ve gözetimi için gerekli düzenlemelerin yapýlarak uygulamaya konulmalýdýr.

Medical and legal evaluation of injuries due to dog bites: a Türkiye study

BACKGROUND: Dog bites are the most common type of injury related to animal bites in our country and worldwide. Dog bite wounds pose significant public health concerns and have medicolegal implications. In this study, we aimed to assess the problems associated with dog bites and propose potential solutions.
METHODS: We conducted a retrospective analysis of 149 cases submitted by judicial authorities to our institution, the Istanbul Council of Forensic Medicine, between 2015 and 2021, to obtain medicolegal expert opinion reports. Information regarding the cases included in the study was obtained from our archives and the National Judicial Network Project (UYAP) system. Data were recorded using Microsoft Excel 2016, and statistical analysis was performed using SPSS 25.0 for Windows (SPSS Inc., Chicago, IL).
RESULTS: The mean age of the cases was 33.7 years, with 57% being male. 56.4% of the incidents occurred in the city center, and 30.9% took place during the summer months. 65.8% (n=98) of the cases were attributed to stray dogs. Superficial injuries without muscle tissue involvement were observed in 54.4% (n=81) of all cases, while 22.8% (n=34) had deep tissue defects or flap injuries, 4.7% (n=7) involved vascularnerve injuries, 16.1% (n=24) included bone fractures, and 2% (n=3) featured visceral injuries. Surgical treatment was performed on 37.5% (n=56) of the cases. Impairments were reported in 22.1% of the cases, with permanent facial scars affecting 16.7% of them. Psychiatric evaluations were required for 48.9% (n=89) of the cases, and 57.5% of them received a diagnosis of post-traumatic stress disorder.
CONCLUSION: People attacked by dogs may experience serious physical or psychological sequelae. Therefore, it is crucial to evaluate all victims using a multidisciplinary approach, addressing their physical, social, and psychological needs, and providing rehabilitation when necessary. Non-governmental organizations, such as those dedicated to the prevention of cruelty to animals, in collaboration with local veterinary services, should play a role in national initiatives to provide objective and humane solutions for both victims and animals.