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

Year 2015, Volume: 18 Issue: 1, 15 - 18, 06.04.2015

Emin Can Ata Yüksel Dereli

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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