Zbrinjavanje poststernomijskih komplikacija terapijom podtlakom

master's thesis

• Title (english): Managment of poststernotomy complications by vacuum therapy
• Author: Marko Kušurin
• Mentor: Rado Žic (mentor)
• Committee member: Srećko Budi (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Rado Žic (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2014-03-19, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery

Abstract

UVOD: Terapija rane podtlakom (eng. „Negative pressure wound therapy“ ; „NPWT“
ili „Vacuum assisted closure“; V.A.C.) široko je rasprostranjena terapijska metoda
koja, različitim mehanizmima potiče cijeljenje akutnih i kroničnih rana. Terapija rane
negativnim tlakom svestrana je metoda te je primjenjiva kod različitih rana, od
dijabetičkog ulkusa, dekubitalnih rana, zbrinjavanja abdominalnih compartment
sindroma do zbrinjavanja sternalnih rana u kardiokirurškim operacijama. Prilikom
kardiokirurških operacija izvođenjem medijalne sternotomije moguća je komplikacija
duboke ili površinske infekcije sternalne regije. Komplicirane duboke sternalne
infekcije povezane su visokim morbiditetom i mortalitetom te se suvremena metoda
terapije negativnim tlakom pokazala kao kvalitetan način liječenja. ---- METODE: Pretražili smo PubMed literaturu koristeći ključne riječi „Vaccum assisted
closure“ , „Negative pressure wound therapy“ , „Poststernotomy wound
complications“ , „sternal wound infections“, „Poststernotomy wound dehiscence“.
Pretežno smo koristili članke u prethodnih 15 godina. ----- REZULTATI: Brojni radovi su objavljeni na temu zbrinjavanja komplikacija medijalne
sternotomije kod kardiokirurških operacija. Danas se ta metoda pokazala
najučinkovitijom u zbrinjavanju dubokih sternalnih infekcija gdje je zabilježen
značajno smanjen mortalitet i morbiditet, uz smanjenje broja reinfekcija a samim
time i potrebe za hospitalizacijom te uštedom novčanih sredstava u zdravstvu. ----- ZAKLJUČAK: Zbrinjavanje komplikacija sternalnih rana terapijom negativnim tlakom
se pokazala vrlo učinkovitom metodom. U usporedbi s prijašnjim metodama
zbrinjavanja zbog svog specifičnog načina djelovanja, jednostavne upotrebe i
umanjenih troškova u odnosu na konvencionalne metode terapija negativnim tlakom
se nametnula kao terapija izbora zbrinjavanja poststernotomijskih komplikacija.

Abstract (english)

BACKGROUND: Negative pressure wound therapy (NPWT) is widely used
method which promotes healing of acute and chronic wounds. It is a versatile
method used for treating all kinds of wounds from diabetic ulcers, bedsores,
management of abdominal compartment syndrome to poststernotomy complications
in cardiac surgery. Complications after median sternotomy include superficial and
deep sternal wound infections. Complicated deep sternal infections are associated
with high morbidity and mortality and the NWPT has been showing great results. ----- METHODS: We searched PubMed literature using the following key words:
„Vacuum assisted closure“, „Negative pressure wound therapy“, „Poststernotomy
wound complications“ , „Sternal wound infections“, „Poststernotomy wound
dehiscence“. We mainly used articles in the past fifteen years. ----- RESULTS: There are numerous papers published regarding NPWT use in
management medial sternotomy complications after cardiac surgery. Today this
method has been shown to be efficient in management of poststernotomy
complications where it showed significant reduction in mortality and morbidity,and
reduced reinfections which reduced hospital treatment costs. ----- CONCLUSION: Management of poststernotomy complications by vacuum
therapy has been shown to be very efficient. In comparison to conventional methods
because of its specific mode of action, simple use and cost reduction compared to
other methods it has imposed as the therapy of choice for management of
poststernotomy complications.

• Keywords: Vacuum assisted closure; Negative pressure wound therapy; poststernotomy wound complications; Sternal wound infections
• Keywords (english): Vacuum assisted closure; Negative pressure wound therapy; poststernotomy wound complications; Sternal wound infections
• Language: croatian
• URN:NBN: urn:nbn:hr:105:598113
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2015-12-15 13:08:16