Açık kalp cerrahisi sonrası sternal yara komplikasyonlarının görülme sıklığı Jackson-Pratt dreni kullanımı ile etkilenir mi?

Amaç: Bu çalışmada median sternotomi ile açık kalp cerrahisi yapılan, Vücut Kütle İndeksi ≥30 kg/m2 olan hastalarda Jackson- Pratt dreninin sternal yara komplikasyonları üzerindeki etkisi incelendi. Çalışma planı: Ocak 2011 - Aralık 2015 tarihleri arasında Vücut Kütle İndeksi ≥30 kg/m2 olan, hastanemizde median sternotomi ile açık kalp cerrahisi yapılan toplam 174 hasta (124 erkek, 50 kadın; ort. yaş 58.2±10.4 yıl; dağılım, 33-78 yıl) retrospektif olarak incelendi. Hastaların 94’üne median sternotomi sonrası Jackson-Pratt dreni takılırken (JP grubu), 80 hastaya dren takılmadı (JP olmayan grup). Her iki grubun ameliyat tipi, hastanede kalış süresi ve komplikasyonlar dahil olmak üzere ameliyat öncesi, sırası ve sonrası sonuçları karşılaştırıldı. Bulgular: Gruplar arasında yaş, cinsiyet, Vücut Kütle İndeksi ve muhtemel risk faktörleri arasında anlamlı bir fark yoktu. Her iki grupta da yoğun bakım ünitesinde median kalış süresi iki gün ve ameliyattan taburculuğa kadar geçen median süre yedi gündü. Gruplar arasında sternal yara komplikasyon oranı açısından istatistiksel olarak anlamlı bir fark bulundu. Dren takılmayan grupta dokuz hastaya (%11.25) kıyasla, dren takılan grupta iki hastada (%2.1) sternal yara komplikasyonu gelişti (p=0.01). Sonuç: Çalışma bulgularımız, median sternotomi sonrasında Jackson-Pratt dren kullanımının vücut kitle indeksi ≥30 kg/m2 olan, açık kalp cerrahisi yapılan hastalarda geleneksel kapatma tekniğine kıyasla, ameliyat sonrası sternal yara komplikasyon riskini azaltmada basit ve güvenli bir yöntem olduğunu göstermektedir.

Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery?

Background: This study aims to investigate the effect of theJackson-Pratt drain on sternal wound complications in patients witha Body Mass Index of ≥30 kg/m2 undergoing open cardiac surgeryvia median sternotomy.Methods: A total of 174 patients (124 males, 50 females; mean age58.2±10.4 years; range, 33 to 78 years) with a Body Mass Indexof ≥30 kg/m2 undergoing cardiac surgery via median sternotomybetween January 2011 and December 2015 in our institutionwere retrospectively analyzed. Of the patients, 94 were inserteda Jackson-Pratt drain (JP group) following median sternotomy,while 80 patients received no drain (non-JP group). Pre-, intra, andpostoperative outcomes of both groups including type of operation,length of hospital stay, and complications were compared.Results: No significant difference in the age, gender, Body MassIndex, and potential risk factors was found between the groups. Themedian of stay in the intensive care unit was two days and the mediantime from operation to discharge was seven days in both groups. Therewas a statistically significant difference in the rate of sternal woundcomplications between the groups. Sternal wound complicationsoccurred in two patients (2.1%) in the drained group, compared to ninepatients (11.25%) in the non-drained group (p=0.01).Conclusion: Our study results show that Jackson-Pratt draininsertion after median sternotomy in patients with a Body MassIndex of ≥30 kg/m2 undergoing open cardiac surgery is a simpleand reliable method to reduce the risk of postoperative sternalwound complications, compared to the conventional closuretechnique.

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