Hasan ERDEM, Ayşe Zehra KARAKOÇ, Seda KARASAKAL, Yeliz KARACI, Arzu ANTAL, Hasan SUNAR

Koroner Baypas Cerrahisi Sonrası Sternal Yara İnfeksiyonunda Negatif Basınç Yardımlı Kapatma

Giriş: Vakum yardımlı kapama yönteminin morbidite ve mortaliteyi azalttığı, hastanede kalış süresini kısalttığı bildirilmiştir. Bu çalışmanın amacı, kliniğimizde koroner baypas cerrahisi sonrası gelişen sternal infeksiyonun vakum destekli kapama sistemi tedavisinin erken sonuçlarını değerlendirmektir. Hastalar ve Yöntem: Hastanemizde Ocak 2016-Aralık 2019 tarihleri arasında, koroner baypas cerrahisi sonrası sternal yara infeksiyonu gelişen 66 hasta çalışmaya dahil edilmiştir. Hastalara cerrahi yara debridmanı ve yabancı cisimlerin uzaklaştırılmasından sonra, postoperatif ortalama 26.56 ± 5.5 günlerinde vakum yardımlı kapatma tedavisi başlanmıştır. Yara dokusunda yeterli kanlanma sağlanması, granülasyon dokusu oluşması ve negatif kültür sonuçları sağlandıktan sonra, uygun prosedür kullanılarak tedavi sonlandırılmıştır. Bulgular: Elli altı hastada derin sternal, 10 hastada yüzeyel sternal infeksiyon tespit edilmiştir. Erken mortalite gelişen 9 (%13.63) hastanın tamamında derin sternal yara infeksiyonu mevcuttur. En sık üretilen mikroorganizmalar Staphylococcus aureus ve Pseudomonas aeruginosa olarak tespit edilmiştir. Ortalama hastanede kalış süresi 39.68 ± 2.48 gün olarak bulunmuştur. Vakum yardımlı kapatma tedavisi ile ilgili komplikasyon yaşanmamıştır. Yaşayan hastaların hiçbirisinde tekrarlayan sternal yara yeri infeksiyonu gözlenmemiştir. Sonuç: Sonuçlarımız vakum yardımlı kapatma yönteminin, primer kapatma uygulanamayacak veya erken dönemde kas filebi ile tedavi edilemeyecek hastalarda güvenli ve etkili bir tedavi yöntemi olduğunu teyit etmiştir

Vacuum-Assisted Closure for Sternal Wound Infection After Coronary Artery Bypass Surgery

Introduction: Vacuum-assisted closure of sternal infected wounds has been reported to improve morbidity and mortality, besides decreasing duration of hospitalization. The aim of this study was to evaluate early outcomes of vacuum-assisted closure of infected sternal wounds after coronary bypass surgery in our clinic. Patients and Methods: Sixty six patients who had sternal wound infection after coronary bypass surgery in our hospital between January 2016 and December 2019 were included in the study. After surgical debridement and removal of foreign materials, vacuum-assisted closure therapy was initiated at a mean postoperative 26.56 ± 5.5 days. After wound healing and negative cultures, treatment was terminated and sternal wounds were closed with appropriate procedures. Results: Fifty six patients (84.84%) had deep sternal infection and 10 patients (15.15%) had superficial sternal infection. Early mortality was 13.63% (nine patients), all having deep sternal infections. The most common microorganisms cultured were Staphylococcus aureus and Pseudomonas aeruginosa. Mean duration of hospitalization was 39.68 ± 2.48 days. No complications related with vacuum-assisted closure were detected. Recurrent sternal wound infection was not observed in any of the surviving patients. Conclusion: Our results confirm that vacuum-assisted closure of wounds is a safe and effective treatment option for patients who are not candidates for primary closure or early muscle flap closure.

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ISSN: 2149-2972
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 1990
Yayıncı: Sağlık Bilimleri Üniversitesi, Kartal Koşuyolu Yüksek İhtisas Eğitim ve Araştırma Hastanesi