THE EFFECT OF VAC USE ON HOSPITAL LENGTH OF STAY IN PATIENTS WITH FOURNIER'S GANGRENE

Year 2022, Volume: 29 Issue: 4, 561 - 565, 27.12.2022

Fırat Canlıkarakaya , Serdar Gökay Terzioğlu , Felat Akıncı

https://doi.org/10.17343/sdutfd.1131065

Abstract

Objective
In this study, it was aimed to Show that the use of
vacuum assisted wound closure (VAC) in patients
with Fournier's gangrene reduces the length of stay
in the hospital.
Material and Method
This is a retrospective study, and it was created by
examining the information of 78 patients diagnosed
with Fournier's gangrene, who applied to our hospital
between 1 June 2019 and 31 January 2022, from the
hospital registry system. Student T test was used
for comparison and p value<0.05 was considered
statistically significant.
Results
While 21 (27%) of the patients were treated with
VAC, 57 (73%) were followed by dressing. The mean
hospitalization period of the patients was found to
be 28.29±17.87. While the mean hospital stay was
19.29 in patients using VAC, it was 31.61 in the group
followed up with dressing. It was found statistically
significant that the use of VAC reduced the length of
stay (p=0.006).
Conclusion
Wound care and follow-up in Fournier's gangrene is
a very laborious process for surgeons who follow up
clinically; the effectiveness of the treatment methods
is equivalent to each other. Therefore, the length of
hospital stay is important, and theuse of VAC reduces
the length of hospital stay. The fact that the number
of patients in our study is 3-4 times higher than the
number of patients found in many systematic reviews
in the literature also suggests that our contribution to
the literature is important.

Keywords

Fournier, Vacuum assisted wound closure (VAC), Wound care

FOURNİER GANGRENİ HASTALARINDA VAC KULLANIMININ HASTANE YATIŞ SÜRESİNE ETKİSİ

Abstract

Amaç
Bu çalışmada fournier gangreni hastalarında vakum
yardımlı yara kapatması (VAC) kullanımının hastanedeki
yatış süresini azalttığını göstermek amaçlanmıştır.
Gereç ve Yöntem
Bu bir retrospektif çalışma olup hastanemize 1 Haziran
2019- 31 Ocak 2022 tarihleri arasında başvurup
fournier gangreni tanısı alan 78 hastanın bilgilerinin
hastane kayıt sisteminden incelenmesiyle oluşturulmuştur.
Karşılaştırmalarda Student T testi kullanılmış
olup p değeri <0,05 istatistiksel olarak anlamlı kabul
edilmiştir.
Bulgular
Hastaların 21’i (%27) VAC ile tedavi edilirken, 57’si
(%73) pansuman ile takip edildi. Hastaların yatış süresi
ortalama 28,29±17,87 olarak saptandı. VAC kullanan
hastalarda yatış süresi ortalama 19,29 iken,
pansuman ile takip edilen grupta 31,61 olarak saptandı.
VAC kullanımının yatış süresini azalttığı istatistiksel
olarak anlamlı bulundu (p=0,006).
Sonuç
Fournier gangreninde yara bakımı ve takibi klinik takibini
yapan cerrahlar açısından oldukça zahmetli bir
süreç olup; tedavi yöntemlerin etkinliği birbirine eş değerdir.
Bu yüzden hastane yatış süresi önemli olup
VAC kullanımı hastane yatış süresini azaltmaktadır.
Çalışmamızdaki hasta sayısının literatürdeki pek çok
sistematik derlemede bulunan hasta sayısının 3-4 kat
fazla olması da literatüre yapacağımız katkının önemli
olduğunu düşündürmektedir.

Keywords

fournier gangreni, vakum yardımlı yara kapatması (VAC), yara bakımı, Fournier, Vacuum assisted wound closure (VAC), Wound care

References

• 1. Yılmazlar T. Fournier Gangreni: Sinsi, Öldürücü, Ancak Tedavi Edilebilir Hastalık. Turk J Colorectal Dis 2012;22:45-49.
• 2. Baurienne H. Sur une plaie contuse qui s’ est terminee par le sphacele de le scrotum. J Med Chir Pharm. 1764;20:251-6.
• 3. Sorensen MD, Krieger JN, Rivara FP, Broghammer JA, Klein MB, Mack CD, et al. Fournier's Gangrene: population based epidemiology and outcomes. The Journal of urology. 2009;181(5):2120-6.
• 4. Thwaini A, Khan A, Malik A, Cherian J, Barua J, Shergill I, et al. Fournier’s gangrene and its emergency management. Postgraduate medical journal. 2006;82(970):516-9.
• 5. Morpurgo E, Galandiuk S. Fournier's gangrene. Surgical Clinics. 2002;82(6):1213-24.
• 6. Yılmazlar T, Işık Ö, Öztürk E, Özer A, Gülcü B, Ercan İ. Fournier’s gangrene: review of 120 patients and predictors of mortality. Ulus Travma Acil Cerrahi Derg. 2014;20(5):333-7.
• 7. Shyam DC, Rapsang AG. Fournier's gangrene. The Surgeon. 2013;11(4):222-32.
• 8. Altunoluk B, Resim S, Efe E, Eren M, Benlioglu C, Kankilic N, et al. Fournier's gangrene: conventional dressings versus dressings with Dakin's solution. International Scholarly Research Notices. 2012 (2012): 762340. doi:10.5402/2012/762340
• 9. Li C, Zhou X, Liu L-F, Qi F, Chen J-B, Zu X-B. Hyperbaric oxygen therapy as an adjuvant therapy for comprehensive treatment of Fournier's gangrene. Urologia Internationalis. 2015;94(4):453-8.
• 10. Ozturk E, Ozguc H, Yilmazlar T. The use of vacuum assisted closure therapy in the management of Fournier's gangrene. The American Journal of Surgery. 2009;197(5):660-5.
• 11. Katušić J, Štimac G, Benko G, Grubišić I, Šoipi Š, Dimanovski J. Management of fournier’s gangrene: case report and literature review. Acta clinica Croatica. 2010;49(4):453-7.
• 12. Canbaz H, Çağlıkülekçi M, Altun U, Dirlik MM, Türkmenoğlu Ö, Taşdelen B, Aydın S. Fournier gangreni: 18 olgudaki prognoza etki eden risk faktörlerinin ve tedavi maliyetinin değerlendirilmesi. Ulusal Travma ve Acil Cerrahi Dergisi. 2010; 16(1): 71 - 76.
• 13. Unal B, Kocer B, Ozel E, Bozkurt B, Yildirim O, Altun B, et al. Fournier gangrene. Approaches to diagnosis and treatment. Saudi medical journal. 2006;27(7):1038-43.
• 14. Syllaios A, Davakis S, Karydakis L, Vailas M, Garmpis N, Mpaili E, et al. Treatment of Fournier's gangrene with vacuum-assisted closure therapy as enhanced recovery treatment modality. in vivo. 2020;34(3):1499-502.
• 15. Franco-Buenaventura D, García-Perdomo HA. Vacuum-assisted closure device in the postoperative wound care for Fournier's gangrene: a systematic review. International Urology and Nephrology. 2021;53(4):641-53.
• 16. Gul M, Sunamak O, Kina U, Gunay E, Akyuz C. Fournier's Gangrene: Our Five-Year Series and the Role of Vacuum-Assisted Closure in the Treatment. Nigerian Journal of Clinical Practice. 2021;24(9):1277.