Açık kalp cerrahisinde geleneksel yönteme alternatif sternum kapama tekniğimiz

Year 2019, , 1246 - 1253, 15.04.2019

Arda Aybars Pala , Hasan İner , Murat Abdulhamit Ercişli

https://doi.org/10.30569/adiyamansaglik.503388

Abstract

Giriş: Açık
kalp cerrahisinde postoperatif süreçte görülen nadir fakat ciddi bir
komplikasyon sternal dehisenstir. Sternal dehisensi önlemek için sternumun iyi
kapatılması şarttır. Çelik tellerle sternumun birleştirilmesi konvansiyonel
sternum kapama tekniği olarak kabul görmektedir. Biz bu çalışmada, kliniğimizde
çelik teller ile uyguladığımız alternatif bir sternum kapama tekniğini ve
sonuçlarını sunmayı amaçladık.

Yöntem: Kliniğimizde
Ocak 2017 ile Ocak 2018 tarihleri arasında açık kalp cerrahisi uygulanmış 115
hastanın verileri retrospektif olarak değerlendirildi. Hastaların hepsinin
sternum kapatılması uyguladığımız alternatif teknik ile yapıldı. Hastaların
sternal dehisens için risk faktörleri ve postoperatif verileri değerlendirildi.

Bulgular: Postoperatif
süreçte %4.3 oranında yüzeysel sternal yara yeri enfeksiyonu gelişti. Hiçbir
hastada 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: Uyguladığımız
sternum kapama tekniğinin sternal komplikasyonları önlemede etkin ve kolay
uygulanabilir bir teknik olduğu düşüncesindeyiz.

Keywords

açık kalp cerrahisi, sternal dehisens, sternum kapama

Alternative sternum closure technique to traditional method in open heart surgery

Abstract

Objectives: Sternal
dehiscence is a rare but serious complication seen in postoperative period in cardiac
surgery. A good closure of the sternum is essential to prevent sternal
dehiscence. Closure of sternum by steel wires is accepted as conventional
sternal closure technique. In this study, we aimed to present an alternative
sternal closure technique and its results with steel wires in our clinic.

Methods: The
data of 115 patients who underwent open heart surgery between January 2017 and
January 2018 in our clinic were evaluated retrospectively. Sternal closure of
all patients was performed with our alternative technique. Risk factors for
sternal dehiscence and postoperative data of patients were evaluated.

Results: In
the postoperative period, superficial sternal wound infection occurred at a
rate of 4.3%. None of the patients developed deep sternal infection
(mediastinitis) and sternal dehiscence. Four patients had mortality and were
not related to sternal complications. Sternal stability and primary wound
healing were achieved in 106 patients (92.1%) without any problem.

Conclusion: We
think that our sternal closure technique is an effective and easily applicable
technique to prevent sternal complications.

Keywords

open heart surgery, sternal dehiscence, sternal closure

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