Umut CANBEK, Ulaş AKGÜN, Nevres Hürriyet AYDOĞAN

YAŞLI KALÇA KIRIKLARINDA HEMİARTROPLASTİ CERRAHİSİ SONRASI DREN YERİNDEN OLUŞAN SIZINTININ MİKROBİYOLOJİK VE BİYOKİMYASAL ANALİZİ, BİR ÖNCÜL ÇALIŞMA

Giriş: Bu çalışmada kalça hemiartroplasti ameliyatı sonrası dren yerinden oluşabilen drenaj sıvısının toplanması ve sıvının biyokimyasal analiz sonuçlarının öncül raporunun sunulması amaçlandı. Gereç ve Yöntem: 01.01.2017- 01.06.2018 tarihleri arasında ≥65 yaş proksimal femur kırığı nedeniyle hemiartroplasti yapılan 190 hasta çalışmaya dahil edildi. Cerrahi sonrası 6. Günde dren yerinden akıntısı olan hastalardan sızan sıvı pediatrik idrar torbası ile toplandı. Toplanan sıvıda ve hastanın plazmasında total protein, albümin, kolesterol, trigliserid düzeylerine bakıldı. Drenaj sıvısında ayrıca dansite, pH ve Rivalta test sonuçları değerlendirilerek transuda/eksuda ayırımı yapıldı. Bulgular: Çalışmanın ön sonuçlarına göre 15 (%7,9) hastada hemiartroplasti cerrahisi sonrası dren yerinden sızıntı olduğu gözlendi. Hastaların 10’u (%.66.,6) erkek, 5’i (%33,4) kadındı. Dren yerinden sızıntısı olan hastaların yaş ortalaması 77,5 ± 8,4 (65-95) idi. Dren yerinden toplanan sıvı analizinde ortalama protein konsantrasyonu 2,07 gr/dl, albümin konsantrasyonu 1,31 gr/dl, LDH 123 U/L, , kolesterol konsantrasyonu 26 mg/dl, trigliserid konsantrasyonu 36 mg/dl, pH :7,6 ve dansite 1,006 saptandı. Tüm hastalarda Rivalta testi negatifti. Sıvılar Light kriterlerine göre değerlendirildiğinde hepsinin transuda vasfında olduğu değerlendirildi. Sonuç: Bu öncül çalışmada hemiartroplasti sonrası uzamış yara drenajı oluşan hastalardan toplanan sıvının biyokimyasal analizini yaptığımızda plazma içeriğine yakın transuda vasfında olduğunu bulduk. Bu sıvının daha ileri yöntemlerle içeriğinin ve nereden kaynaklandığının belirlenmesinin gerekli olduğunu düşünüyoruz.

BIOCHEMICAL ANALYSIS OF LEAKAGE FROM DRAIN SITE IN ELDERLY PATINTS AFTER HEMIARTROPLASTY SURGERY, A PRELIMINARY REPORT

Introduction: In this study, it was aimed to collect drainage fluid which can occur after hip hemiarthroplasty and to present the preliminary report about biochemical analysis results. Materials and Methods: 190 patients aged ≥65 years who underwent hemiarthroplasty for proximal femur fracture between 01.01.2017 and 01.06.2018 were included in the study. On the 6th day after surgery, leaked fluid from patients with drainage was collected by pediatric urine collection bag. Levels of total protein, albumin, LDH, cholesterol and triglyceride in both collected fluid and plasma were measured. In addition, the density, pH and Rivalta test results of the leakage fluid were evaluated, and transudate/exudate differentiation was performed.Results: According to the preliminary results of the study, leakage was observed in 15 (7.9%) patients after hemiarthroplasty surgery. Ten patients (66.6%) were male and 5 (33.4%) were female. The mean age of patients with leakage was 77.5 ± 8.4 (65-95). The mean total protein concentration in the fluid analysis was 2.07 g/dl, the mean albumin concentration was 1.31 g / dl, the mean LDH was 123 U/L, the mean cholesterol concentration was 26 mg/dL, the mean triglyceride concentration was 36 mg/dL, the mean pH was 7.6 and the mean density was 1.006. All Rivalta test results found to be negative. According to Light criteria, all fluids were evaluated as transudative. Conclusion: In this preliminary study, we found that the biochemical content of leakage from drain site after hemiarthroplasty was close to the plasma. We think that it is necessary to determine the content and the origin of this liquid with more advanced methods.

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