Yaralanma sonrası ekstremitelerin yumuşak dokusunda gözlenen yabancı cisimlere cerrahi yaklaşım
Yükleniyor...
Tarih
2019
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Dicle Üniversitesi Tıp Fakültesi
Erişim Hakkı
Attribution-NonCommercial 3.0 United States
info:eu-repo/semantics/closedAccess
info:eu-repo/semantics/closedAccess
Özet
Giriş: Ekstremitelerde yabancı cisim yaralanmaları sık görülmelerine rağmen, tedavi yaklaşımları konusunda literatürde oldukça az bilgi bulunmaktadır. Bu çalışmada yumuşak dokuda yabancı cisim batması nedeniyle cerrahi tedavi uygulanan hastalarla ilgili epidemiyolojik bir çalışma amaçlanmıştır.
Yöntemler: 2012-2015 yılları arasında yumuşak dokuda yabancı cisim yaralanması nedeniyle cerrahi tedavi uygulanan 52 erkek ve 57 kadın hastadan oluşan toplam 109 hastanın hastane arşivinden hasta dosyalarına ve radyoloji PACS sisteminden radyolojik goDžruDžntuDžlerine ulaşıldı. Hastaların demografik bilgileri, batan yabancı cisimlerin tipi ve battıgǍı ortam, tetanoz ve antibiyotik profilaksisi yapılıp yapılmadıgǍı, anestezi tipleri, yatış suDžreleri ve komplikasyonlar gibi bulgular tespit edildi.
Bulgular: Opere edilen 109 hastanın ortalama yaşı 28 (3-68) olarak tespit edildi. 62 (%56.9) hastada yaralanma ev ortamında olurken, 47 (%43.1) hastada ise ev dışı ortamda yabancı cisim battığı tespit edildi. Batan yabancı cisimler 43 hastada iğne, 28 hastada cam, 21 hastada metal cisim, 12 hastada ateşli silah yaralanması sonucu metal yabancı cisim ve 5 hastada ise tahta parçasına bağlı yaralanma tespit edildi. Yaralanmalar %58,7 alt ekstremitede görülürken %41,3 üst ekstremitede görüldü. Yabancı cisim çıkartılması için cerrahi uygulanan 78 (%71,6) hastaya lokal anestezi uygulanırken, diğer hastalara rejyonel veya genel anestezi uygulandı. Lokal anestezi uygulanan hastalar aynı gün, genel ve rejyonel anestezi uygulanan hastalar ise cerrahi sonrası 1. günde taburcu edildi. Takiplerde hiçbir komplikasyon gözlenmedi. Sonuç: Yabancı cisimler çoğunlukla ev ortamında oluşan yaralanmalardır. Direk radyografi yabancı cisimlerin büyük bir kısmında oldukça yararlıdır, fakat metal dışı yabancı cisimlerin belirlenmesinde ultrasonografi ve/veya manyetik rezonans incelemeden yararlanılmalıdır. Cerrahi girişim için anestezinin tipi hastanın yaşına ve yabancı cismin lokalizasyonuna göre seçilmelidir.
Objective: Although foreign body injuries are common in the extremities, there is little information about treatment approaches in the literature. In this study, an epidemiological study of patients who underwent surgical treatment for foreign body ingestion in soft tissue was aimed. Methods: Between 2012 and 2015, a total of 109 patients (52 males and 57 females) who underwent surgical treatment for soft tissue foreign body injuries, received radiological images from the hospital archives and radiology PACS. Demographic data of the patients, type of foreign bodies sinking and submerged media, tetanus and antibiotic prophylaxis, anesthesia types, length of stay and complications were determined. Results: The mean age of 109 patients was 28 (3-68) years. In 62 (56.9%) patients, the injury occurred in the home environment and in 47 (43.1%) patients, foreign body sank in the external environment. Sinking foreign bodies were detected by needle in 43 patients, glass in 28 patients, metal body in 21 patients, metal foreign body as a result of gunshot injury in 12 patients and injury due to wooden component in 5 patients. The injuries were seen in 58.7% of the lower extremities and 41.3% in the upper extremity. While local anesthesia was applied to 78 (71.6%) patients who underwent surgery to remove foreign bodies, regional or general anesthesia was applied to the other patients. The patients who underwent local anesthesia were discharged on the same day, and general and regional anesthesia patients were discharged on the 1st postoperative day. No complications were observed during follow-up. Conclusion: Foreign bodies are mostly injuries in the home environment. Direct radiography is very useful in most of the foreign bodies, but ultrasonography and / or magnetic resonance imaging should be used to identify non-metallic foreign bodies. The type of anesthesia for surgical intervention should be based on the age of the patient and the localization of the foreign body.
Objective: Although foreign body injuries are common in the extremities, there is little information about treatment approaches in the literature. In this study, an epidemiological study of patients who underwent surgical treatment for foreign body ingestion in soft tissue was aimed. Methods: Between 2012 and 2015, a total of 109 patients (52 males and 57 females) who underwent surgical treatment for soft tissue foreign body injuries, received radiological images from the hospital archives and radiology PACS. Demographic data of the patients, type of foreign bodies sinking and submerged media, tetanus and antibiotic prophylaxis, anesthesia types, length of stay and complications were determined. Results: The mean age of 109 patients was 28 (3-68) years. In 62 (56.9%) patients, the injury occurred in the home environment and in 47 (43.1%) patients, foreign body sank in the external environment. Sinking foreign bodies were detected by needle in 43 patients, glass in 28 patients, metal body in 21 patients, metal foreign body as a result of gunshot injury in 12 patients and injury due to wooden component in 5 patients. The injuries were seen in 58.7% of the lower extremities and 41.3% in the upper extremity. While local anesthesia was applied to 78 (71.6%) patients who underwent surgery to remove foreign bodies, regional or general anesthesia was applied to the other patients. The patients who underwent local anesthesia were discharged on the same day, and general and regional anesthesia patients were discharged on the 1st postoperative day. No complications were observed during follow-up. Conclusion: Foreign bodies are mostly injuries in the home environment. Direct radiography is very useful in most of the foreign bodies, but ultrasonography and / or magnetic resonance imaging should be used to identify non-metallic foreign bodies. The type of anesthesia for surgical intervention should be based on the age of the patient and the localization of the foreign body.
Açıklama
Anahtar Kelimeler
Yumuşak doku, Yaralanma, Yabancı cisim, Ekstremite, Lokalizasyon, Soft tissue, Injury, Foreign body, Extremity, Localization
Kaynak
Dicle Tıp Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
46
Sayı
2
Künye
Uludağ, A., Tosun, H.B., Çiçek, N., Şirik, M., Uludağ, Ö., Atiç, R. (2019). Yaralanma sonrası ekstremitelerin yumuşak dokusunda gözlenen yabancı cisimlere cerrahi yaklaşım. Dicle Tıp Dergisi. 46(2), 215-223
