Pilonidal sinüs cerrahisinde limberg flep transpozisyonunda kapalı vakumlu dren'in etkinliği
Date
2005
Authors
Samsa, M. Veysi
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Pilonidal sinüs cerrahisinin ideal bir tedavi yöntemi olarak kabul edilen limberg flep transpozisyonu sonrası, yarada kan ve seroma birikimi, komplikasyonlara ve tedavi maliyetlerinin artmasına yol açabilir. Bu çalışma; limberg flep transpozisyonunda vakumlu dren kullanımının komplikasyonları önlemesindeki etkinliğini belirlemek ve olguların hastanede yatış süresi ile normal günlük aktiviteye dönüş zamanına olan etkilerini araştırmak amacıyla yapılmıştır. Uludağ Üniversitesi Tıp Fakültesi Genel Cerrahi kliniğinde yapılan prospektif çalışma 44 hastada gerçekleştirilmiş, olgular kapalı vakumlu dren konulmayan (Grup I) ve kapalı vakumlu dren konulan (Grup II) gruptan birine randomize alınmıştır. Tüm olgular spinal anesteziyle, Jack-Knife pozisyonunda opere edilerek postoperatif 1. gün taburcu edilmiştir. 2-5-7 ve 10.günlerde poliklinik takipleri yapılan ve postoperatif komplikasyon gelişmeyen olgularda cilt sütürleri 10. günde alınmıştır. Drenlerin çekilme süresi flebin postsakral alana yapışmasını sağlamak amacıyla 9. güne kadar uzatılmıştır. Grup l'de; 5 olguda yara ayrılması, 3 olguda enfeksiyon, 1 olguda hematom saptanırken, Grup ll'de ise; 2 olguda yara ayrılması, 1 olguda da enfeksiyon gelişmiştir. Gruplar arasında yara ayrılması sıklığı istatistiksel olarak anlamlı bulunmuştur (p‹005). Enfeksiyon, hematom Grup l'de daha sık gözlenmesine karşın gruplar arasında istatistiksel farklılık saptanmamıştır (p›005). Grup l'de günlük aktiviteye dönüş süresi 9.23±4.32, Grup ll'de 5.18±2.30 gündür ve gruplar arasında istatistiksel olarak anlamlı bir farklılık saptanmıştır (p‹005). Sonuç olarak; modern tasarım ve minimal kontaminasyon riski sayesinde sosyal yaşamı etkilemeden rahatça taşınabilen ve hastalar tarafından kolaylıkla uyum sağlanan vakumlu drenlerin, limberg flep transpozisyonunda kullanılmasıyla hastanede yatış süresinin uzamadığı, olguların hızlı iyileşme ve azalan komplikasyonlar sayesinde günlük aktiviteye dönüşlerinin hızlandığı kanısındayız.
Hematoma and seroma collection in the wound after limberg flap transposition which is an ideal method for the surgical treatment of pilonidal sinus may cause complications and increase in patients'costs.ln this study the efficacy of closed-suction drains after limberg flap tranposition on preventing these complications and hospital stay time and time for returning to daily activities were examined. Our study consists of 44 patients operated in the surgical Clinic of Uludağ University Medical school. Patients were randomly divided into two groups: Group I; patients with no suction drain and Group II; patients having a suction drain. All patients had be encalled examined on the 2nd.5th and 7th day of discharge. No complications had occured. Stures had been taken on the 10th day of operation. Suction drains were taken on the 9th of operation in order to help the flap connect tothe postsacral fascia. In Group I, wound dehishence in 5 cases, infection in 3 cases and hematoma in one case occured where as in Group II, wound dehishence were seen in two patients and infection was seen in one patient. Wound dehishence ratio was statistically different (p<0,05). lnfection was seen more freguently in Group I but this was not statistically meaningful! (p>0,05). Time for returning to daily activics was 9.23±4.32 days and 5.18 ±2.30 days for Group I and Group II, respectively and there was statistically difference between two groups (p<0,05). As a conclusion; with the aid of closed-suction drains that can be easily carried and accepted by the patients as a result their modern design and minimal contamination risk, hospital stay time after limberg flap transposition for pilonidal sinus is not lengthen and time for returning to daily activities dicreases because of the declining complication ratio and increasing healing rate.
Hematoma and seroma collection in the wound after limberg flap transposition which is an ideal method for the surgical treatment of pilonidal sinus may cause complications and increase in patients'costs.ln this study the efficacy of closed-suction drains after limberg flap tranposition on preventing these complications and hospital stay time and time for returning to daily activities were examined. Our study consists of 44 patients operated in the surgical Clinic of Uludağ University Medical school. Patients were randomly divided into two groups: Group I; patients with no suction drain and Group II; patients having a suction drain. All patients had be encalled examined on the 2nd.5th and 7th day of discharge. No complications had occured. Stures had been taken on the 10th day of operation. Suction drains were taken on the 9th of operation in order to help the flap connect tothe postsacral fascia. In Group I, wound dehishence in 5 cases, infection in 3 cases and hematoma in one case occured where as in Group II, wound dehishence were seen in two patients and infection was seen in one patient. Wound dehishence ratio was statistically different (p<0,05). lnfection was seen more freguently in Group I but this was not statistically meaningful! (p>0,05). Time for returning to daily activics was 9.23±4.32 days and 5.18 ±2.30 days for Group I and Group II, respectively and there was statistically difference between two groups (p<0,05). As a conclusion; with the aid of closed-suction drains that can be easily carried and accepted by the patients as a result their modern design and minimal contamination risk, hospital stay time after limberg flap transposition for pilonidal sinus is not lengthen and time for returning to daily activities dicreases because of the declining complication ratio and increasing healing rate.
Description
Keywords
Pilonidal sinüs, Limberg flep, Vakumlu dren, Limberg flap, Closed - suction drain
Citation
Samsa, M. V. (2005). Pilonidal sinüs cerrahisinde limberg flep transpozisyonunda kapalı vakumlu dren'in etkinliği. Yayınlanmamış tıpta uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.