Ventrikül destek cihazı uygulanan hastalarda driveline çıkış yeri yara bakımı: Sistematik derleme

Amaç: Bu çalışmada ventrikül destek cihazı uygulanan hastaların driveline çıkış yeri bakım yöntemleri ile ilgili çalışmalar sistematik olarak belirlendi ve incelendi. Çalışma planı: 2008 - 2017 yılları arasında İngilizce ve Türkçe yayımlanan ventrikül destek cihazı uygulanan hastalarda driveline çıkış yeri bakımına ilişkin çalışmalar uluslararası Science Direct, PubMed, Web of Science, Scopus ve ulusal veri tabanlarında tarandı. Toplam 83 makaleden, dahil edilme kriterlerini karşılayan yedi araştırma makalesi çalışma kapsamına alındı. Bulgular: Araştırma kapsamına giren çalışmalardan driveline çıkış yerinin temizliğinde kullanılan ajanlar, pansuman kapama örtüleri, pansuman değiştirme sıklığı ve driveline kablo sabitleyici cihazlara ilişkin bulgular elde edildi. Driveline çıkış yeri bakımında cilt temizliğinde klorheksidin solüsyonunun ve pansuman kapama örtüsü olarak steril gaz spanç ile transparan örtü kullanımının en çok tercih edilen yöntemler olduğu belirlendi. Pansuman değiştirme sıklığı merkezlere göre oldukça farklılık gösteriyordu ve tüm çalışmalarda kablo sabitleyici araçlar kullanılmıştı. Sonuç: Ventrikül destek cihazı uygulanan hastalarda driveline çıkış yeri bakımına yönelik altın standart bir yöntem mevcut değildir ve driveline çıkış yeri bakıma ilişkin araştırmalar sınırlı sayıdadır. Driveline çıkış yeri bakımına ilişkin daha güçlü kanıtlar sunacak geniş kapsamlı randomize kontrollü çalışmaların yapılması önerilmektedir.

Wound care of the driveline exit site in patients with a ventricular assist device: A systematic review

Background: This study aims to systematically define and analyze the studies on driveline exit site care methods for patients with a ventricular assist device.Methods: The studies related to driveline exit site care of the patients with a ventricular assist device published in English and Turkish between 2008 and 2017 were reviewed from the international Science Direct, PubMed, Web of Science, Scopus, and the national databases. Of a total of 83 articles, a total of seven research articles which met the inclusion criteria were included in the study.Results: Findings related to the agents used in the cleaning of the driveline exit site, dressing closures, dressing change frequency, and use of driveline anchoring devices were obtained from studies included in the research. It was found that chlorhexidine solution for skin cleaning and sterile gauze sheets and transparent covering for dressing closure were the most preferred methods for the driveline exit site care. Dressing change frequency varied considerably from center to center and anchoring devices were used in all studies.Conclusion: There is no gold standard method for the driveline exit site care of patients with a ventricular assist device and researches on the driveline exit site care seem to be limited. It is recommended that large- scale, randomized-controlled studies should be conducted which would provide a stronger proof of the driveline exit site care.

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