Hayati AYGÜN, Albert ÇAKAR, Atıl ATİLLA, Bilgin IRLAYICI, Mahmut AYTEKİN, İsmail AĞIR, Cihangir İSLAM

Zor İyileşen Alt Ekstremite Yaralarının Tedavisinde Negatif Basınçlı Yara Tedavi Yönteminin Etkinliği ve Sonuçları

Özet: Amaç: Alt ekstremitelerin kronik enfekte yaraları, ortopedi pratiğinde sıkça karşılaşılan ve birden fazla etyolojiye bağlı oluşan, ciddi morbidite ve mortalite nedenleridir. Etyolojisi ne olursa olsun fizyopatolojisinde mikrovasküler yetmezliğe bağlı iyileşme zorluğu ve enfeksiyona yatkınlık vardır. Tedavisinde bir çok yardımcı yöntem kullanılmaktadır. Bunlardan biri de vakum yardımlı yara kapama (VAC) yada negatif basınçlı yara tedavi (NBYT) yöntemidir. Bu çalışma ile zor iyileşen yaraların tedavisinde NBYT yönteminin erkinliği araştırılması amaçlandı.Gereç-yöntem: Kliniğimizde çeşitli etyolojik faktörelere bağlı kronik yaraları olan ve tedavisinde negatif basınçlı yara tedavi sistemleri kullanılan 5 hastalık bir olgu serisinin verileri analiz edilerek, tedavi sonuçları geriye dönük olarak değerlendirilmiştir.Bulgular ve sonuç: Alt ekstremitelerinde kronik yarası bulunan ve yara kronisite süresi 53,3 gün olan beş hasta ortalama 31 (11-51) gün süre ile tedavi edildi. Hastalara -75 ile -150 mmHg basınç ile NBYT uygulandı. Çalışmanın sonuçlarına göre NBYT, dolaşım bozukluğu nedeni ile ortaya çıkan alt ekstremite yaralarının tedavisinde başarılı bir yöntem olarak bulundu.

Anahtar Kelimeler:

Kronik yara, vakum yardımlı kapama, enfeksiyon, diyabet, Buerger hastalığı, negatif basınçlı yara tedavisi.

The Efficiency and Results Of Negative Pressure Wound Therapy Method In The Treatment Of SlowHealing Lower Extremity Wounds

Aim: The chronic infected wounds are commonly encountered in the orthopedic practice and occur due to several etiological factors. They are responsible for serious morbidity and mortality. Regardless of the etiology, the underlying factors at these wounds are healing problems and predisposition to infection due to microvascular insufficiency. There are several methods for the treatment of these wounds. One of them is vacuum assisted closure systems (VAC) or negative pressure wound therapy (NPWT). The aim of present study is to evaluate the NPWT methods’ efficacy in the treatment of chronic lower extremity wounds with insufficient microvascular blood supply.Material-method: The data and results of a case series of five patients with several etiologies who had been treated by NPWT are analyzed and the results are evaluated retrospectively in this study.Findings and results: Five patients with chronic wound in their lower extremities due to microvascular circulation insufficiency were treated with NPWT for a period ranging from 11 to 51 days (average 31 days). The chronicity time was average 53,3 days in patients. NPWT was applied in -75 mmHg with -150 mmHg pressures. According to findings of this study, the NPWT was found influent as a method for the treatment of chronic wounds with insufficient blood circulation in lower extremities.

Keywords:

Chronic wounds, vacuum assisted closure, infection, diabetes, Buerger disease, negative pressure wound therapy.,

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Yazışma Adresi / Correspondence: Hayati AYGÜN Kafkas Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Departmanı, 36100 Kars Türkiye e-posta: hayatiaygun@gmail.com