Yüksek Riskli Hastalarda Poliglikonat (Maxon) Sütürle Desteklenen Sternum Kapama Tekniğinin Aseptik Sternal Ayrışma Üzerine Etkisi

Abstract

Giriş: Sternal ayrışma, kardiyak cerrahi sonrası ciddi bir komplikasyondur. Bu çalışmanın temel amacı yüksek riskli hastalarda poliglikonat sütür (Maxon) ile desteklenen sternum kapama tekniğinin sternal ayrışmayı önlemedeki etkinliğinin araştırılmasıdır.

Hastalar ve Yöntem: Bu retrospektif çalışmaya, (Aralık 2011-Ocak 2013), kardiyak cerrahi için standart median sternotomi uygulanan 136 hasta dahil edildi. Tüm hastalar sternal ayrışma için obezite, osteoporoz, kronik obstrüktif akciğer hastalığı, kronik aktif sigara içiciliği gibi bir veya daha fazla risk faktörüne sahipti. Tüm hastalarda sternum kapatılması esnasında çelik tele ilave olarak interkostal aralıklardan geçilerek poliglikonat sütürler konuldu.

Bulgular: Hiçbir hastada sternal ayrışma veya mediastinit görülmedi. Sadece 3 hastada (%2.2), sternal ayrışma olmadan sternum alt kısmında yüzeysel yara infeksiyonu gözlendi ve bunlar da antibiyotik tedavisi ile başarıyla tedavi edildi.

Sonuç: Bu çalışma, yüksek riskli hastalarda, klasik çelik tele ilave olarak interkostal aralıklardan poliglikonat sütürler geçilerek desteklenen sternum kapama yönteminin sternal stabiliteyi artırdığını ve aseptik sternal ayrışmayı önlediğini göstermektedir.

Keywords

• Cerrahi sütür,makson,cerrahi yara ayrışması,sternum

Effects of Polyglyconate (Maxon) Suture Reinforced Sternum Closure Technique on Aseptic Sternal Dehiscence in High Risk Patients

Abstract

Introduction: Sternal dehiscence is a serious complication after cardiac surgery. The main objective of this study will be to determine the effects of polyglyconate suture (Maxon) reinforced sternum closure technique on prevention of aseptic sternal dehiscence in high-risk patients.

Patients and Methods: This retrospective study (December 2011 to January 2013) comprised 136 consecutive patients undergoing standard median sternotomy for cardiac procedures. All of these patients have one or more risk factor of sternal dehiscence such as obesity, osteoporosis, chronic obstructive pulmonary disease and chronic active cigarette smoker. In all patients, in addition to steel wire during sternal closure polyglyconate sutures were placed, passing through the intercostal space.

Results: No sternal dehiscence or mediastinit occurred these patients. Only 3 patients (2.2%) were observed superficial wound infection at lower part of sternum without sternum dehiscence and treated successfully by antibiotic therapy.

Conclusion: This study shows that besides the classic steel wire, additional polyglyconate sutures placed intercostal spaces can be inhance sternum stability and prevent aseptic sternal dehiscence in high risk patients.

Keywords

• Sutures,maxon,wound dehiscence surgical,sternum

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