Yıl: 2020 Cilt: 7 Sayı: 1 Sayfa Aralığı: 42 - 45 Metin Dili: İngilizce DOI: 10.4274/jus.galenos.2019.3013 İndeks Tarihi: 22-11-2020

Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene

Öz:
Objective: Management of Fournier’s gangrene (FG) includes large wound debridement, broad-spectrum antibiotic, wound care and re-debridementif necessary. The aim of our study was to compare standard open wound care and vacuum-assisted closure (VAC) therapy in patients with FG.Materials and Methods: Thirty-three patients (29 males and 4 females) who underwent surgery for FG were enrolled in the present study. The datawas evaluated retrospectively. The patients were divided into two groups according to wound care after large wound debridement. Standard openwound care with antibiotic pomade was performed twice a day in 14 patients and VAC therapy was performed every 48-72 hours in 17 patients.The data of the two groups were compared.Results: Twenty-three (69.7%) patients had Diabetes Mellitus and 20 patients (60%) had poor hygiene. The re-debridement rate in patients whoreceived standard open wound care was statistically higher than in those who underwent VAC therapy (p=0.016). There were no statisticallysignificant differences in mortality rate, length of hospital stay and need for reconstruction between the groups. When the data were analyzed,no statistically significant difference was found in FG Severity index score, length of hospital stay and mortality rate. However, the relationshipbetween mortality rate and location of lesion was statistically significant (p=0.03). Four patients died, 3 (75%) due to wide necrotizing fasciitisextending to the abdominal wall.Conclusion: The present study showed that the technique used for wound care did not influence mortality, need for reconstruction and length ofhospital stay. The only advantage of VAC therapy was decreased re-debridement rate in patients with FG.
Anahtar Kelime:

Fornier Gangreni Tedavisinde Standart Açık Yara Pansumanı ve Vakum Yardımlı Kapamanın Karşılaştırılması

Öz:
Amaç: Fornier gangreninin tedavisi, agresif yara debridmanı, geniş spektrumlu antibiyotik kullanımı, yara bakımı ve gerekirse tekrar debridman gerektirir. Çalışmamızın amacı Fornier gangrenli hastaların tedavisinde klasik yara bakımının ve vakum yardımlı kapama malzemelerinin karşılaştırılmasıdır. Gereç ve Yöntem: Çalışmaya Fornier gangreni nedeniyle cerrahi yapılan otuz üç hasta (29 erkek ve 4 kadın) dahil edildi. Veriler retrospektif olarak değerlendirildi. Hataların 23 tanesi (%69,7) Diyabet hastalığı vardı ve 20 hastada (%60) kötü hijyen mevcuttu. Hastalar debridman sonrası yara bakımına göre 2 gruba ayırıldı. On dört hastaya antibiyotikli pomad ile günde 2 kez standart yara pansumanı yapıldı. On yedi hasta, 48-72 saatte bir değişen VAC tedavisi ile takip edildi. İki grubun verileri karşılaştırıldı. Bulgular: Hastaların 23 tanesi (%69,7) Diyabet hastalığı vardı ve 20 hastada (%60) kötü hijyen mevcuttu. Klasik pansuman ile takip edilen hastalarda tekrar debridman oranları VAC ile takip edilen hastalara göre istatistiksel olarak fazlaydı (p=0,016). Mortalite oranları, hastanede yatış süreleri ve rekonstrüksiyon ihtiyaçlarında anlamlı farklılık saptanmadı. Veriler analiz edildiğinde FG Şiddeti indeksi skorlarında, hastanede yatış süresinde ve mortalite oranlarında istatistiksel bir fark bulunmadı. Ancak mortalite oranı ile lezyon lokalizasyonu arasındaki ilişki istatistiksel olarak anlamlıydı (p=0,03). Mortalitenin görüldüğü 4 hastanın 3’ü (%75) abdominal duvara yayılan geniş nekrotizan fasiit nedeniyle öldü. Sonuç: Bu çalışma, yara bakımı tekniğinin mortalite, rekonstrüksiyon ihtiyacı ve hastanede yatış süresini etkilemediğini göstermiştir. VAC tedavisinin tek avantajı yeniden debridman oranındaki azalmadır.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA BALİ Z, AKDENİZ C, MÜEZZİNOĞLU MD T, ÜÇER MD O, KARA E (2020). Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. , 42 - 45. 10.4274/jus.galenos.2019.3013
Chicago BALİ Zülfikar Ulaş,AKDENİZ Caner Buğra,MÜEZZİNOĞLU MD Talha,ÜÇER MD Oktay,KARA Eray Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. (2020): 42 - 45. 10.4274/jus.galenos.2019.3013
MLA BALİ Zülfikar Ulaş,AKDENİZ Caner Buğra,MÜEZZİNOĞLU MD Talha,ÜÇER MD Oktay,KARA Eray Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. , 2020, ss.42 - 45. 10.4274/jus.galenos.2019.3013
AMA BALİ Z,AKDENİZ C,MÜEZZİNOĞLU MD T,ÜÇER MD O,KARA E Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. . 2020; 42 - 45. 10.4274/jus.galenos.2019.3013
Vancouver BALİ Z,AKDENİZ C,MÜEZZİNOĞLU MD T,ÜÇER MD O,KARA E Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. . 2020; 42 - 45. 10.4274/jus.galenos.2019.3013
IEEE BALİ Z,AKDENİZ C,MÜEZZİNOĞLU MD T,ÜÇER MD O,KARA E "Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene." , ss.42 - 45, 2020. 10.4274/jus.galenos.2019.3013
ISNAD BALİ, Zülfikar Ulaş vd. "Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene". (2020), 42-45. https://doi.org/10.4274/jus.galenos.2019.3013
APA BALİ Z, AKDENİZ C, MÜEZZİNOĞLU MD T, ÜÇER MD O, KARA E (2020). Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. Journal of Urological Surgery, 7(1), 42 - 45. 10.4274/jus.galenos.2019.3013
Chicago BALİ Zülfikar Ulaş,AKDENİZ Caner Buğra,MÜEZZİNOĞLU MD Talha,ÜÇER MD Oktay,KARA Eray Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. Journal of Urological Surgery 7, no.1 (2020): 42 - 45. 10.4274/jus.galenos.2019.3013
MLA BALİ Zülfikar Ulaş,AKDENİZ Caner Buğra,MÜEZZİNOĞLU MD Talha,ÜÇER MD Oktay,KARA Eray Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. Journal of Urological Surgery, vol.7, no.1, 2020, ss.42 - 45. 10.4274/jus.galenos.2019.3013
AMA BALİ Z,AKDENİZ C,MÜEZZİNOĞLU MD T,ÜÇER MD O,KARA E Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. Journal of Urological Surgery. 2020; 7(1): 42 - 45. 10.4274/jus.galenos.2019.3013
Vancouver BALİ Z,AKDENİZ C,MÜEZZİNOĞLU MD T,ÜÇER MD O,KARA E Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene. Journal of Urological Surgery. 2020; 7(1): 42 - 45. 10.4274/jus.galenos.2019.3013
IEEE BALİ Z,AKDENİZ C,MÜEZZİNOĞLU MD T,ÜÇER MD O,KARA E "Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene." Journal of Urological Surgery, 7, ss.42 - 45, 2020. 10.4274/jus.galenos.2019.3013
ISNAD BALİ, Zülfikar Ulaş vd. "Comparison of Standard Open Wound Care and Vacuum-assisted Closure Therapy in Fournier’s Gangrene". Journal of Urological Surgery 7/1 (2020), 42-45. https://doi.org/10.4274/jus.galenos.2019.3013