Median sternotomiden sonra 48-72 saat içinde yapılan duşun yara enfeksiyonuna, ağrı ve konfora etkisi
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Dosyalar
Tarih
2017
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Ege Üniversitesi, Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu araştırmanın amacı, median sternotomiden sonra 48-72 saat içinde yapılan duşun yara enfeksiyonu, ağrı ve hasta konforuna etkisini incelemektir. Araştırma randomize kontrollü deneysel bir çalışmadır. Araştırma kapsamına bir üniversite hastanesinin Kalp ve Damar Cerrahisi Kliniği'nde Aralık 2016- Eylül 2017 tarihleri arasında koroner arter baypas grefti ameliyatı geçiren 18 yaşından büyük toplam 51 hasta alındı. Ameliyattan sonraki 48-72 saat içinde duş aldırılmış 26 hasta Girişim grubunu, sütürleri alınıncaya kadar duş aldırılmayan 25 hasta ise araştırmanın Kontrol grubunu oluşturdu. Çalışma kapsamına alınan tüm hastalardan ilk pansumandan önce, banyo öncesi, taburculukta, ameliyattan sonraki 14. gün yara yeri sürüntü örneği alındı ve lokal enfeksiyon belirtisi açısından değerlendirildi. Ameliyattan bir ay sonra hastalar tarafından çekilen yara bölgesi fotoğrafları telefon aracılığıyla araştırmacıya gönderildi. Tüm sonuçlar sternal yara enfeksiyonu gelişimi açısından bir Enfeksiyon Kontrol Komitesi Üyesi tarafından değerlendirildi. Her iki gruptaki hastaların ağrı, konfor ve memnuniyet düzeyleri "Görsel Kıyaslama Ölçeği Formu" ile değerlendirildi. Araştırma uygulanmadan önce girişimsel olmayan klinik araştırmalar etik kurulu, kurum ve hastalardan yazılı izin alındı. Araştırmanın verileri, Statistical Package For Social Science (SPSS) 18.0 programı kullanılarak değerlendirildi. Girişim ve Kontrol grubu arasında tanıtıcı özellikler ve ameliyata ilişkin değişkenler açısından istatistiksel olarak anlamlı bir fark bulunmadı (p<0.05). Girişim grubunda sternal yara enfeksiyonu gelişmesi (%7.7) Kontrol grubuna kıyasla (%32.0) düşük bulundu ve aradaki fark istatistiksel olarak anlamlı idi (p<0.05). Girişim grubundaki hastaların duş sonrası ağrı düzeyleri Kontrol grubuna göre düşük, konfor ve memnuniyet düzeyleri ise yüksektir. Aradaki fark istatistiksel olarak anlamlı bulundu (p<0.05). Sonuç olarak, median sternotomiden sonra 48-72 saat içinde yapılan duşun sternal yara enfeksiyonu, ağrı ve hasta konforu üzerine olumsuz etkisinin bulunmadığı saptandı. Kalp cerrahisi sonrası 48-72 saat içesinde hastalara duş aldırılması ve bu çalışmanın farklı örneklem grubunda çalışılması önerilmektedir.
This study aimed to investigate the effect of baths taken 48-72 hours after Median Sternotomy on wound infections, pain and healing comfort of patients. The randomized and controlled Intervention study was composed of a total of 51 patients older than 18 who had undergone coronary artery bypass graft surgery in the Cardiovascular Surgery Clinic of a university hospital in the period of December 2016-September 2017. 26 patients who were given baths in the 48-72 hours after the surgery constituted the Intervention group while 25 patients who were not given baths until after their sutures were removed made up the Control group. Swab samples were taken from the wound sites of all patients participating in the study before the first dressing, before bathing, during discharge and on the 14th day of the surgery and these samples were evaluated for local infection symptoms. Photos of wound sites taken by the patients one month after the surgery were sent to the researcher via phone. All results were assessed by an Infection Control Committee for the development of sternal wound infection. The pain, healing comfort and satisfaction levels of all patients in both groups were evaluated by using "Visual Analog Scale Form". Before the implementation of the study, written permissions were received from non-Intervention clinical studies ethics board, the institution and the patients. Study data were analyzed with the help of Statistical Package for Social Science (SPSS) 18.0 program. No statistically meaningful differences were found between the Intervention and Control groups in terms of identifying characteristics and variables related to the surgery (p<0.05). The sternal wound infection (7.7%) that develops in the Intervention group was found to be lower than that of the Control group (32.0% ) with a significant statistical difference between them (p<0.05). Pain levels of the patients in the Intervention group after the bath was found to be lower compared to those of the patients in the Control group whereas their healing comfort and satisfaction levels were higher with a statistically significant difference (p<0.05). As a result, it was identified that baths taken after 48-72 hours following median sternotomy had no negative effect on sternal wound infection, pain and healing comfort. Suggestions of the study include having patients take baths during the 48-72 hour period after cardiac surgery and conducting this study with different sample groups.
This study aimed to investigate the effect of baths taken 48-72 hours after Median Sternotomy on wound infections, pain and healing comfort of patients. The randomized and controlled Intervention study was composed of a total of 51 patients older than 18 who had undergone coronary artery bypass graft surgery in the Cardiovascular Surgery Clinic of a university hospital in the period of December 2016-September 2017. 26 patients who were given baths in the 48-72 hours after the surgery constituted the Intervention group while 25 patients who were not given baths until after their sutures were removed made up the Control group. Swab samples were taken from the wound sites of all patients participating in the study before the first dressing, before bathing, during discharge and on the 14th day of the surgery and these samples were evaluated for local infection symptoms. Photos of wound sites taken by the patients one month after the surgery were sent to the researcher via phone. All results were assessed by an Infection Control Committee for the development of sternal wound infection. The pain, healing comfort and satisfaction levels of all patients in both groups were evaluated by using "Visual Analog Scale Form". Before the implementation of the study, written permissions were received from non-Intervention clinical studies ethics board, the institution and the patients. Study data were analyzed with the help of Statistical Package for Social Science (SPSS) 18.0 program. No statistically meaningful differences were found between the Intervention and Control groups in terms of identifying characteristics and variables related to the surgery (p<0.05). The sternal wound infection (7.7%) that develops in the Intervention group was found to be lower than that of the Control group (32.0% ) with a significant statistical difference between them (p<0.05). Pain levels of the patients in the Intervention group after the bath was found to be lower compared to those of the patients in the Control group whereas their healing comfort and satisfaction levels were higher with a statistically significant difference (p<0.05). As a result, it was identified that baths taken after 48-72 hours following median sternotomy had no negative effect on sternal wound infection, pain and healing comfort. Suggestions of the study include having patients take baths during the 48-72 hour period after cardiac surgery and conducting this study with different sample groups.
Açıklama
Anahtar Kelimeler
Kalp Cerrahisi, Ameliyat Sonrası Bakım, Duş, Yara İyileşmesi, Yara Enfeksiyonu, Ameliyat Sonrası Ağrı, Konfor, Cardiac Surgery, Post Operative Care, Bath, Wound Healing, Wound İnfection, Post Operative Pain, Healing Comfort
