Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence

AKINCI, Esat; CENAL, Ali Rıza; TEKÜMİT, Hayrettin; TATAROĞLU, Cenk; Uzun, Kemal

Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence

Hayrettin TEKÜMİT, (Avrupa Şafak Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Ali Rıza CENAL, (Avrupa Şafak Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Cenk TATAROĞLU, (Avrupa Şafak Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Kemal UZUN, (Avrupa Şafak Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Esat AKINCI (Avrupa Şafak Hastanesi, Kardiyoloji Kliniği, İstanbul, Türkiye)

Anadolu Kardiyoloji Dergisi

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Yıl: 2009 Cilt: 9 Sayı: 5 Sayfa Aralığı: 411 - 416 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence

Öz:

Amaç: Sternal dehisens ciddi ve ölümcül bir komplikasyondur. Biz bu çalışmamızda, non-mikrobiyal sternal dehisens gelişim ve seyri üzerine iki sternal kapama tekniğinin -figür 8 ve basit tek tek telleme- etkilerini mukayese ettik. Yöntemler: Kliniğimizde, Ocak 2002- Ağustos 2008 tarihleri arasında mediyan sternotomi yolu ile açık kalp ameliyatı uygulanan 6211 erişkin hastanın tıbbi kayıtları, non-mikrobiyal sternal dehisens gelişimi açısından retrospektif olarak incelendi. Sternal dehisens gelişen 90 (%1.44) izole koroner baypas cerrahisi (KABG) olgusunun klinik seyri, sternal kapama tekniği -figür 8 veya basit tek tek telleme- temelinde Student t test, Mann Whitney U test, Ki-kare testi ve Fisher Exact testi ile analiz edildi. Sağkalım süreleri Kaplan Meier testi ile karşılaştırıldı. Bulgular: Figür 8 ve basit tek telleme teknikleri arasında, sternal dehisens gelişim sıklığı benzerdi (sırasıyla %1.46 ve %1.43). İlaveten, her iki teknik arasında sternal dehisens gelişim sonrası mortalite ve postoperatif seyir (sternal onarım zamanı, uzamış yoğun bakım süresi, intraaortik balon desteği ve inotropik ajan kullanımı, revizyon ve serebrovasküler olay) oranları benzerdi. Her iki grupta birer hastada mortalite görüldü (sırasıyla %2.6 ve %1.9). Sonuç: Bu çalışmanın bulguları, izole “on-pump” KABG uygulanan olgularda, non-mikrobiyal sternal dehisens gelişim ve sonrası seyir bağlamında; en sık kullanılan iki teknik olan figür 8 ve basit tek tek telleme arasında fark olmadığını düşündürmektedir.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Non-mikrobiyal sternal dehisens gelişen olgularda figür 8 ve basit tek tek telleme ile kapama tekniklerinin mukayesesi

Öz:

Objective: Sternal dehiscence is a serious and potentially devastating complication. The present study compared the effects of two sternal closure techniques, simple wire technique and figure-of-eight technique, on the development and outcome of non-microbial sternal dehiscence. Methods: Medical records of all adult patients (n=6211) that underwent cardiac operations in our clinic through median sternotomy between January 2002 and August 2008 were retrospectively reviewed for the development of non-microbial sternal dehiscence. The outcomes of 90 (1.44%) isolated on-pump coronary artery bypass surgery (CABG) cases that developed dehiscence were analyzed with Student's t test, Mann Whitney U test, Chi-square test and Fisher’s Exact test according to the type of sternal closure: figure-of-eight or simple wire technique. Survival analysis was made with Kaplan Meier test. Results: Figure-of-eight and simple wire technique were associated with similar rates of sternal dehiscence (1.46% and 1.43%, respectively). In addition, after the development of sternal dehiscence, these techniques were associated with similar mortality rates and postoperative outcomes (time to sternal re-fixation, prolonged ICU stay, intraaortic balloon counterpulsation use and chest re-exploration inotropic agent use and postoperative cerebrovascular accident). One patient died in each group (2.6% vs. 1.9%, respectively). Conclusion: In conclusion, present findings suggest that the most commonly used sternal closure techniques, figure-of-eight technique and simple wire technique, may have similar outcomes in terms of development and prognosis of non-microbial dehiscence in patient undergoing isolated on-pump CABG operations.

Anahtar Kelime:

Konular: Kalp ve Kalp Damar Sistemi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	TEKÜMİT H, CENAL A, TATAROĞLU C, Uzun K, AKINCI E (2009). Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. , 411 - 416.
Chicago	TEKÜMİT Hayrettin,CENAL Ali Rıza,TATAROĞLU Cenk,Uzun Kemal,AKINCI Esat Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. (2009): 411 - 416.
MLA	TEKÜMİT Hayrettin,CENAL Ali Rıza,TATAROĞLU Cenk,Uzun Kemal,AKINCI Esat Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. , 2009, ss.411 - 416.
AMA	TEKÜMİT H,CENAL A,TATAROĞLU C,Uzun K,AKINCI E Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. . 2009; 411 - 416.
Vancouver	TEKÜMİT H,CENAL A,TATAROĞLU C,Uzun K,AKINCI E Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. . 2009; 411 - 416.
IEEE	TEKÜMİT H,CENAL A,TATAROĞLU C,Uzun K,AKINCI E "Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence." , ss.411 - 416, 2009.
ISNAD	TEKÜMİT, Hayrettin vd. "Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence". (2009), 411-416.

APA	TEKÜMİT H, CENAL A, TATAROĞLU C, Uzun K, AKINCI E (2009). Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. Anadolu Kardiyoloji Dergisi, 9(5), 411 - 416.
Chicago	TEKÜMİT Hayrettin,CENAL Ali Rıza,TATAROĞLU Cenk,Uzun Kemal,AKINCI Esat Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. Anadolu Kardiyoloji Dergisi 9, no.5 (2009): 411 - 416.
MLA	TEKÜMİT Hayrettin,CENAL Ali Rıza,TATAROĞLU Cenk,Uzun Kemal,AKINCI Esat Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. Anadolu Kardiyoloji Dergisi, vol.9, no.5, 2009, ss.411 - 416.
AMA	TEKÜMİT H,CENAL A,TATAROĞLU C,Uzun K,AKINCI E Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. Anadolu Kardiyoloji Dergisi. 2009; 9(5): 411 - 416.
Vancouver	TEKÜMİT H,CENAL A,TATAROĞLU C,Uzun K,AKINCI E Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence. Anadolu Kardiyoloji Dergisi. 2009; 9(5): 411 - 416.
IEEE	TEKÜMİT H,CENAL A,TATAROĞLU C,Uzun K,AKINCI E "Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence." Anadolu Kardiyoloji Dergisi, 9, ss.411 - 416, 2009.
ISNAD	TEKÜMİT, Hayrettin vd. "Comparison of figure-of-eight and simple wire sternal closure techniques in patients with non-microbial sternal dehiscence". Anadolu Kardiyoloji Dergisi 9/5 (2009), 411-416.