Ulus Travma Acil Cerrahi Derg. 2010; 16(5): 427-432

Perfore apandisit ameliyatýnda dren kullanýmýnýn komplikasyonlara etkisi

Ali Ezer, Nurkan Törer, Kenan Çalýþkan, Tamer Çolakoðlu, Alper Parlakgümüþ, Sedat Belli, Sedat Yýldýrým
Baþkent Üniversitesi Týp Fakültesi, Genel Cerrahi Anabilim Dalý, Adana Araþtýrma Ve Ugulama Merkezi, Adana, Türkiye

AMAÇ
Perfore apandisit ameliyatlarýnda halen tartýþma konusu olan dren kullanýmýnýn komplikasyonlara etkisi araþtýrýldý.
GEREÇ VE YÖNTEM
Mayýs 1999- Ocak 2009 tarihleri arasýnda hastanemizde ameliyat edilen, ameliyat esnasýnda veya sonrasýnda perfore apandisit olduðu saptanan hastalarýn dren koyulma durumlarý, cerrahi alan enfeksiyonlarý, diðer komplikasyonlar ve hastanede yatýþ süreleri geriye dönük tarandý.
BULGULAR
Çalýþma süresi içinde 208 hasta (ortalama yaþ 41,05±16,30) perfore apandisit tanýsý ile ameliyat edildi. Hastalarýn 128’i (%61,5) erkek idi. Ortanca þikayet süresi 2 (daðýlým, 1-15) gün idi. 83 hastaya (%39,9) dren koyulmuþtu. Ortanca dren kalýþ süresi 3 (daðýlým, 1-7) gün idi. Dren koyulan hastalarda cerrahi alan enfeksiyonu, yara ayrýþmasý, komplikasyon geliþme oraný ve tekrar hastaneye yatýþ gerekliliði anlamlý ölçüde yüksek bulundu. Dren koyulanlarda þikayetlerin baþlamasý ile ameliyat arasýnda geçen süre, ameliyat sonrasý antibiyotik verilme süresi ve ameliyat sonrasý hastanede kalýþ süresi anlamlý olarak daha uzun bulundu (hepsi için p=0,001). Dren koyulan ve koyulmayan hastalarda sýrasýyla yandaþ hastalýk oraný %39,8-%19,2, orta hat kesisi ile ameliyat edilenler %20,5 -%3,2 oranýnda bulundu. Yaþlýlarda daha sýk dren koyulduðu görüldü. Dren koyulmasýnýn çok deðiþkenli analizde cerrahi alan enfeksiyonu geliþimini baðýmsýz olarak etkilediði saptandý (p<0,001).
SONUÇ
Perfore apandisit ameliyatlarýndan sonra dren kullanýmý cerrahi alan enfeksiyonlarýný arttýran, buna baðlý olarak da hastanede yatýþ süresini uzatan bir iþlem olarak gözükmektedir.

Anahtar Kelimeler: Cerrahi alan enfeksiyonu, dren; perfore apandisit; komplikasyon.

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Use of drainage in surgery for perforated appendicitis: the effect on complications

Ali Ezer, Nurkan Törer, Kenan Çalýþkan, Tamer Çolakoðlu, Alper Parlakgümüþ, Sedat Belli, Sedat Yýldýrým
Baskent University,faculty Of Medicine, Department Of General Surgery, Adana Medical And Research Center, Adana,turkey

BACKGROUND
We aimed to investigate the use of drainage in surgery for perforated appendicitis and to determine its effect(s) on complications.
METHODS
Two-hundred and eight patients diagnosed with perforated appendicitis between May 1999 and January 2009 were retrospectively evaluated in terms of using drainage with respect to surgical infections and other complications and duration of hospital stay.
RESULTS
A total of 208 patients diagnosed with perforated appendicitis underwent surgery. The mean age of the patients was 41.05 ± 16.30 years. Of the 208 patients, 128 (61.5%) were male. The median duration of complaints was 2 days (1-15 days). Drainage was applied in 83 patients (39.9%). The median duration of drainage was 3 days (1-7 days). Surgical infections, wound dehiscence, other complications, and re-hospitalization rates were significantly higher in patients with drainage. The mean time from appearance of complaints to surgery, the duration of hospitalization and antibiotic treatment were also longer in the drainage group (p=0.001 for all). A higher rate of the patients with an accompanying disease (39.8%-19.2%) and midline incision (20.5%-3.2%) and of the elderly patients had drainage. Multivariate analyses showed that using a drain independently affected surgical infections (p<0.001).
CONCLUSION
It can be concluded that using a drain after surgery for perforated appendicitis increases surgical infections and in turn the duration of hospital stay.

Keywords: Surgical infections, drain; perforated appendicitis; complication.

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