Nevres Hürriyet AYDOĞAN, Cem Yalın KILINÇ, Emre GÜLTAÇ, Fatih İlker CAN, Hıdır TANYILDIZI, Ahmet Emrah AÇAN

Total Eklem Artroplastisini Takiben D-Dimer'ın Progresyonu ile Erken Postoperative Yara ve Eklem Enfeksiyonu Arasındaki İlişki

Eklem artroplastisi sonrası postoperative enfeksiyon, azımsanamayacak derecede insidansı olan kötü bir komplikasyondur ve erken tespiti önemlidir. Bu retrospektif çalışmanın amacı, eklem artroplastisi sonrası postoperatif DDimer düzeyindeki değişimi diğer proinflamatuar mediatörlerle birlikte değerlendirmek ve D-Dimer progresyonu ile erken postoperative yara enfeksiyonu arasındaki ilişkiyi belirlemektir. Ocak 2017'den Mart 2018'e kadar, elektif primer total kalça artroplastisi (49 hasta) veya total dizartroplastisi (72 hasta) ameliyatı yapılan 121 hastanın retrospektif bir değerlendirmesi yapıldı. CRP, INR, troponin ve D-Dimer düzeyleri preoperatif 1. gün, postoperatif 1., 3., 7., 14. Günlerde kaydedildi ve perioperative değişiklikler karşılaştırıldı. Tüm hastalar enfeksiyon açısından takip edildi. Çalışmaya toplam 121 hasta (% 76.9 kadın, % 23.1 erkek) dahil edildi. Postoperatif CRP ve INR değerlerinin değişkenliği benzerdi. D-Dimer erken postoperative dönemde CRP'den daha hızlı yükselme ve düşüş gösterdi. Postoperatif dönemde artan akut faz reaktanları olan CRP ve DDimer'ın eş zamanlı yükselmesinin ardından, enfeksiyondan bağımsız olarak süreç içinde CRP'nin normal değerlerine dönerken D-Dimer'ın tekrar pik yaptığı görüldü. Yirmi dört hastada (%19.8) erken yara enfeksiyonu tespit edildi ve yara enfeksiyonu olan hastaların %70'inde erken postoperatif D-Dimer artışı görüldü ve ayrıca erken dönemde yara enfeksiyonu olan hastalardaki CRP düzeyindeki artış ile D-Dimer yükselişi arasında anlamlı bir ilişki bulundu (p

Correlation between Progress of D-Dimer Following Total Joint Arthroplasty and Early Postoperative Wound and Joint Infection

Postoperative infection after joint arthroplasty is a bad complicationwith incontrovertible incidence and early detection is essential. Thepurpose of this retrospective study was to evaluate postoperativechange of D-Dimer level after joint arthroplasty along with otherproinflammatory mediators and to determine the correlationbetween progress of D-Dimer and early postoperative infection.From January 2017 until March 2018, a retrospective evaluation of121 patients operated for elective primary total hip arthroplasty (49patients) or total knee arthroplasty (72 patients) was conducted.CRP, INR, troponin and D-Dimer level were noted on thepreoperative day 1, postoperative days 1, 3, 7, 14 and perioperativechanges compared. All patients were followed up for infection. 121patients included in the study. The variability of postoperative CRPand INR values was similar. D-Dimer showed a more rapid rise andfall than CRP in early postoperative period. Early wound infectionswere detected in 24 patients (19.8%) and 70% of the patients withwound infection had early postoperative D-Dimer increase and alsoa significant relationship was found between the patients withwound infection in the early period and the increase in CRP level(p

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