İnguinal Hematoma Bağlı Cerrahi Debridman Gerektiren Yara Yeri İnfeksiyonu: Perkütan Koroner Girişimin Nadir Bir Komplikasyonu

Year 2012, Volume: 1 Issue: 1, 52 - 54, 01.04.2012

Yüksel Çiçek Elif Ergül Murtaza Emre Durakoğlugil Ayşe Ertürk

Abstract

Altmış üç yaşında tip 2 diabetes mellitus ve kronik böbrek yetmezliği olan bayan hastaya anjiyoplasti ve stent uygulandı. İşlemden yaklaşık 10 dakika sonra femoral bölgede 10x7 cm’lik büyük bir hematom gelişti. Vasküler kılıf, heparin etkisinin geçmesi beklenmeden çekildi. Cilt ve cilt altı dokusunun beslenmesinin bozulmasına bağlı olarak 5.gündeciltte erozyon ve ardından açık ayara oluştu. Erken dönemde antibiyotik başlanmış olmasına rağmen yara giderek derinleşti ve bu nedenle 15. günde cerrahi debridman yapıldı. Takipte yara bölgesinin perfüzyonu düzeldi ve açıklık suture edildi. Hastada başka bir komplikasyon gelişmedi

Keywords

Yara enfeksiyonu, Perkütan koroner girişim, İnguinal hematom

Groin Infection Due to Inguinal Hematoma Necessitating Surgical Debridement: A Rare Complication of Percutaneous Coronary Intervention

Abstract

A 63 year old obese female with chronic renal failure and type 2 diabetes mellitus underwent angioplasty and stent implantation. A large femoral hematoma 10x7 cm in diameter appeared after 10 minutes, and the sheath was withdrawn immediately without waiting heparin effect to subside. Skin erosion and subsequent open wound developed due to the disruption of vessel supply at the fifth day. Despite the early initiation of antibiotics, the wound progressed deeper; hence, surgical debridement was performed at the 15th day. During the follow-up, the wound tissue became healthy with better perfusion and was sutured with no other complication. We think that drainage may provide tissue perfusion by maintaining better blood supply, in case of large hematoma at the puncture site. Radial artery puncture may be preferable in older and obese patients

Keywords

Groin infection, Percutaneous coronary intervention, Inguinal hematoma

References

• Steffenino G, Dutto S, Conte L, et al. Vascular access complications after cardiac catheterisation: a nurse- led quality assurance program. Eur J Cardiovasc Nurs 2006; 5(1): 31-6.
• Koreny M, Riedmyeller E, Nikfardjam M, Siostrzonek P, Muellner M. Arteriel puncture closing devices compared with standed manuel compression after cardiac catheterization. JAMA 2004; 291: 350- 7.
• Kaufman JL. Pelvic hemorrhage after percutaneus femoral angiography, AM J Roentgenol 1984: 143; 335-6.
• Sagel SS, Siogel MJ, Stanley RJ, Jost RG. Detection of tomography. Am J Roentgenol 1988; 129: 403-7.
• Willey JM, White CJ, Urestsky BF. Non-coronary complications of coronary intervention. Catheter Cardiovascular Interv 2002; 2: 257-67.
• Holmes SJ, Yales H, Mazz JJ. Rectus sheath hematoma as acause of acute abdominal pain. Am Fam Physician 2001; 64(10): 1681-2.
• Wyman RM, Safian RD, Portway V, Skillman JJ, McKay RG, Baim DS. Current complications of diagnostic and therapeutic cardiac catheterization. J Am Coll Cardiol 1988; 12(6): 1400-6.
• Frazee BW, Flaherty JP. Septic endarteritis of the femoral artery following angioplasty. Rev Infect Dis 1991; 13(4): 620-3.
• Sari I, Davutoglu V, Soydinc S, Aksoy M. Deep inguinal infection after percutaneous coronary intervention. N Z Med J 2008; 121(1269): 68-70.
• Polgreen PM, Diekema DJ, Vandeberg J, et al. Risk factors for groin wound infection after femoral artery catheterization: a case-control study. Infect Control Hosp Epidemiol 2006; 27(1): 34-7.
• Edwards JE, Tillman DB, Miller ME, Pitchon HE: Infectionand diabetes mellitus. West J Med 1979; 130: 515-21.