Turkiye Klinikleri Journal of Nursing Sciences

.: CASE REPORTS
Virginia Henderson Teorisi Doğrultusunda Koroner Baypas Ameliyatlı Bireyde Görülen Sternal Yara Enfeksiyonu Bakım Yönetimi
Care Management of Sternal Wound Infection in Individuals with Coronary Bypass Surgery According to Virginia Henderson Theory
Sevil PAMUK CEBECİa , Büşra SEMERCİb
aEskişehir Osmangazi Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Esasları ABD, Eskişehir, Türkiye
bEskişehir Osmangazi Üniversitesi Sağlık Bilimleri Enstitüsü, Hemşirelik Esasları ABD, Eskişehir, Türkiye
Turkiye Klinikleri J Nurs Sci. 2023;15(3):892-902
doi: 10.5336/nurses.2023-96387
Article Language: TR
Full Text
ÖZET
 Koroner arter hastalığı, ateroskleroz genel kategorisinde olan damar hastalığıdır. Ateroskleroz, damar lümeninde zamanla ilerleyerek patolojik bir tablo oluşturmakta, damar lümeninde biriken plaklar, lümenin daralmasına ve kan akışının zorlanmasına neden olmaktadır. Kompleks koroner arter hastalığı olan hastalarda semptomları hafifletmek ve prognozu iyileştirmek için koroner arter baypas greft (KABG) ameliyatı yaygın olarak kullanılmaktadır. KABG ameliyatı sırasında ve sonrasında çok sayıda komplikasyon meydana gelebilir. Bu komplikasyonlardan sternum yara enfeksiyonu, sternotomiyi takiben gelişebilir ve yaygın olarak görülmektedir. Sternum yara enfeksiyonu gelişen hastada; lokal eritem, eksüda miktarında artma, ağrı, ateş ve anormal solunum semptomları görülebilmektedir. Erken belirtilere karşı dikkatli olunmalı, uygun sürüntüler, kültürler alınmalıdır. Enfeksiyona bağlı yara ayrışmaları yüzeyselse iyi planlanmış yara bakımı ya da negatif basınçlı yara tedavisi ile desteklenmiş pansumanlarla iyileşebilir. Ancak büyük veya komplike sternal yara ayrılmasının rekonstrüktif cerrahi gerektirdiği de bildirilmektedir. Bu makalede, Virginia Henderson Teorisi doğrultusunda koroner baypas ameliyatlı bireyde görülen sternal yara enfeksiyonu bakım yönetimi olgu sunumu şeklinde sunulmuştur.

Anahtar Kelimeler: Sternum; yara enfeksiyonu; yara pansumanı; Virginia Henderson teorisi; hemşirelik
ABSTRACT
 Coronary artery disease is a vascular disease in the general category of atherosclerosis. Atherosclerosis progresses over time in the vessel lumen and creates a pathological picture, plaques accumulating in the vessel lumen cause narrowing of the lumen and forcing the blood flow. Coronary artery bypass graft (CABG) surgery is widely used to relieve symptoms and improve prognosis in patients with complex coronary artery disease. Numerous complications can occur during and after CABG surgery. Among these complications, sternum wound infection may develop following sternotomy and is common. In the patient who developed sternum wound infection; local erythema, increased amount of exudate, pain, fever and abnormal respiratory symptoms can be seen. Attention should be paid to such early signs and appropriate swabs and cultures should be taken. If the wound dehiscence due to infection is superficial, it can be healed with well-planned wound care or dressings supported by negative pressure wound treatment. However, it has also been reported that large or complicated sternal wound dehiscence requires reconstructive surgery. In this article, sternal wound infection care management in an individual with coronary bypass surgery in accordance with the Virginia Henderson theory is presented as a case report.

Keywords: Sternum; wound infection; wound dressing; Virginia Henderson theory; nursing
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