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使用杰克逊-普拉特引流管会影响心脏直视手术后胸骨伤口并发症的发生率吗?

Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery?

作者信息

Salihi Salih, Kızıltan H Tarık

机构信息

Department of Cardiovascular Surgery, Okan University Hospital, İstanbul, Turkey.

Department of Cardiovascular Surgery, Hasan Kalyoncu University Hospital, İstanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2019 Jan 1;27(1):15-22. doi: 10.5606/tgkdc.dergisi.2019.15659. eCollection 2019 Jan.

Abstract

BACKGROUND

TThis study aims to investigate the effect of the Jackson-Pratt drain on sternal wound complications in patients with a Body Mass Index of ≥30 kg/m undergoing open cardiac surgery via median sternotomy.

METHODS

A total of 174 patients (124 males, 50 females; mean age 58.2±10.4 years; range, 33 to 78 years) with a Body Mass Index of ≥30 kg/m undergoing cardiac surgery via median sternotomy between January 2011 and December 2015 in our institution were retrospectively analyzed. Of the patients, 94 were inserted a Jackson-Pratt drain (JP group) following median sternotomy, while 80 patients received no drain (non-JP group). Pre-, intra, and postoperative outcomes of both groups including type of operation, length of hospital stay, and complications were compared.

RESULTS

No significant difference in the age, gender, Body Mass Index, and potential risk factors was found between the groups. The median of stay in the intensive care unit was two days and the median time from operation to discharge was seven days in both groups. There was a statistically significant difference in the rate of sternal wound complications between the groups. Sternal wound complications occurred in two patients (2.1%) in the drained group, compared to nine patients (11.25%) in the non-drained group (p=0.01).

CONCLUSION

Our study results show that Jackson-Pratt drain insertion after median sternotomy in patients with a Body Mass Index of ≥30 kg/m undergoing open cardiac surgery is a simple and reliable method to reduce the risk of postoperative sternal wound complications, compared to the conventional closure technique.

摘要

背景

本研究旨在调查对于体重指数(BMI)≥30kg/m²且接受正中开胸心脏手术的患者,使用杰克逊-普拉特引流管(Jackson-Pratt drain)对胸骨伤口并发症的影响。

方法

回顾性分析了2011年1月至2015年12月期间在我院接受正中开胸心脏手术、BMI≥30kg/m²的174例患者(124例男性,50例女性;平均年龄58.2±10.4岁;范围33至78岁)。其中,94例患者在正中开胸术后插入了杰克逊-普拉特引流管(JP组),而80例患者未放置引流管(非JP组)。比较了两组患者术前、术中和术后的结果,包括手术类型、住院时间和并发症情况。

结果

两组患者在年龄、性别、BMI及潜在风险因素方面无显著差异。两组患者在重症监护病房的中位停留时间均为两天,从手术到出院的中位时间均为七天。两组患者在胸骨伤口并发症发生率上存在统计学显著差异。引流组有2例患者(2.1%)发生胸骨伤口并发症,而非引流组有9例患者(11.25%)发生(p=0.01)。

结论

我们的研究结果表明,对于BMI≥30kg/m²且接受心脏直视手术的患者,与传统闭合技术相比,正中开胸术后插入杰克逊-普拉特引流管是一种简单可靠的降低术后胸骨伤口并发症风险的方法。

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