TY - JOUR T1 - Açık kalp cerrahisinde geleneksel yönteme alternatif sternum kapama tekniğimiz TT - Alternative sternum closure technique to traditional method in open heart surgery AU - Pala, Arda Aybars AU - İner, Hasan AU - Ercişli, Murat Abdulhamit PY - 2019 DA - April Y2 - 2019 DO - 10.30569/adiyamansaglik.503388 JF - Adıyaman Üniversitesi Sağlık Bilimleri Dergisi JO - ADYÜ Sağlık Bilimleri Derg PB - Adıyaman University WT - DergiPark SN - 2458-9179 SP - 1246 EP - 1253 VL - 5 IS - 1 LA - tr AB - Giriş: Açıkkalp cerrahisinde postoperatif süreçte görülen nadir fakat ciddi birkomplikasyon sternal dehisenstir. Sternal dehisensi önlemek için sternumun iyikapatılması şarttır. Çelik tellerle sternumun birleştirilmesi konvansiyonelsternum kapama tekniği olarak kabul görmektedir. Biz bu çalışmada, kliniğimizdeçelik teller ile uyguladığımız alternatif bir sternum kapama tekniğini vesonuçlarını sunmayı amaçladık.Yöntem: KliniğimizdeOcak 2017 ile Ocak 2018 tarihleri arasında açık kalp cerrahisi uygulanmış 115hastanın verileri retrospektif olarak değerlendirildi. Hastaların hepsininsternum kapatılması uyguladığımız alternatif teknik ile yapıldı. Hastalarınsternal dehisens için risk faktörleri ve postoperatif verileri değerlendirildi.Bulgular: Postoperatifsüreçte %4.3 oranında yüzeysel sternal yara yeri enfeksiyonu gelişti. Hiçbirhastada derin sternal enfeksiyon (mediastinit) ve sternal dehisens gelişmedi.Dört hastada sternal komplikasyona bağlı olmayan mortalite görüldü. 106 hastada(%92.1) sorunsuz olarak sternum stabilitesi ve primer yara iyileşmesi sağlandı.Sonuç: Uyguladığımızsternum kapama tekniğinin sternal komplikasyonları önlemede etkin ve kolayuygulanabilir bir teknik olduğu düşüncesindeyiz. KW - açık kalp cerrahisi KW - sternal dehisens KW - sternum kapama N2 - Objectives: Sternaldehiscence is a rare but serious complication seen in postoperative period in cardiacsurgery. A good closure of the sternum is essential to prevent sternaldehiscence. Closure of sternum by steel wires is accepted as conventionalsternal closure technique. In this study, we aimed to present an alternativesternal closure technique and its results with steel wires in our clinic.Methods: Thedata of 115 patients who underwent open heart surgery between January 2017 andJanuary 2018 in our clinic were evaluated retrospectively. Sternal closure ofall patients was performed with our alternative technique. Risk factors forsternal dehiscence and postoperative data of patients were evaluated.Results: Inthe postoperative period, superficial sternal wound infection occurred at arate of 4.3%. None of the patients developed deep sternal infection(mediastinitis) and sternal dehiscence. Four patients had mortality and werenot related to sternal complications. Sternal stability and primary woundhealing were achieved in 106 patients (92.1%) without any problem.Conclusion: Wethink that our sternal closure technique is an effective and easily applicabletechnique to prevent sternal complications. CR - 1. Casha AR, Yang L, Kay PH, Saleh M, Cooper GJ. A biomechanical study of median sternotomy closure techniques. Eur J Cardiothorac Surg. 1999;15(3):365-9. CR - 2. Robicsek F, Fokin A, Cook J, Bhatia D. Sternal instability after midline sternotomy. Thorac Cardiovasc Surg. 2000;48(1):1-8. CR - 3. Losanoff JE, Richman BW, Jones JW. Disruption and infection of median sternotomy: a comprehensive review. Eur J Cardiothorac Surg. 2002;21(5):831-9. CR - 4. Cohen DJ, Griffin LV. A biomechanical comparison of three sternotomy closure techniques. Ann Thorac Surg. 2002;73(2):563-8. CR - 5. Kamiya H, Al-Maisary SS, Akhyari P, Ruhparwar A, Kallenbach K, Lichtenberg A et al. 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UR - https://doi.org/10.30569/adiyamansaglik.503388 L1 - https://dergipark.org.tr/en/download/article-file/650812 ER -