HASTALARIN AMELİYAT ÖNCESİ TIBBİ OPTİMİZASYONU
Alparslan Yurtbay
Samsun Üniversitesi, Tıp Fakültesi, Ortopedi ve Travmatoloji AD, Samsun, Türkiye
Yurtbay A. Hastaların Ameliyat Öncesi Tıbbi Optimizasyonu. Karaaslan F. editör. Periprostetik Eklem Enfeksiyonunda Tanı ve Tedavi. 1. Baskı. Ankara: Türkiye Klinikleri; 2024. p.33-41.
ÖZET
Protez eklem enfeksiyonu (PEE), eklem replasmanı ameliyatından sonra ortaya çıkabilecek zorlu bir kompli- kasyondur. PEE riskini azaltmak, ameliyat öncesi ve sırasında dikkatli hasta optimizasyonu gerektirir. Beslenme durumu, obezite ve diabetes mellitus yönetiminin etkili bir şekilde ele alınması, genel sağlık ve ameliyat öncesi sonuçları önemli ölçüde iyileştirebilir. Ameliyat öncesi sigarayı bırakmayı teşvik etmenin, ameliyat sonrası yara komplikasyonlarının sıklığını potansiyel olarak azalttığı gösterilmiştir. Enfeksiyon riskini en aza indirirken altta yatan inflamatuar süreçleri etkili bir şekilde yönetmek için immünosüpresif ilaçlarda değişiklikler yapmak önemlidir. Ek olarak, aktif klinik olarak teşhis edilen enfeksiyonlar uygun şekilde tedavi edilene kadar elektif cerrahiyi geciktirmek önerilir. Staphylococcus aureus taşıyıcılarının taranması ve dekolonizasyonu, toplum çapında mupirosin direncini önemli ölçüde etkilemeden cerrahi alan enfeksiyonu oranında bir azalma ile ilişkilendirilmiştir. Dahası, perioperatif antimikrobiyal profilaksi ve antikoagülasyonun dikkatli bir şekilde yönetilmesi esastır. Hastaların önemli yumuşak doku eksiklikleri gösterdiği durumlarda, bir plastik cerrahla ameliyat öncesi konsültasyon alınması önerilir ve koordineli bir cerrahi plan geliştirmek çok önemlidir. Eklem artroplastisi geçiren hastalarda ameliyat öncesi değerlendirmeye yönelik kapsamlı, multidisipliner bir yaklaşım, ilgili hastalar için olumlu sonuçlar elde etme potansiyeline sahiptir.
Anahtar Kelimeler: Artroplasti; Replasman; Enfeksiyon; Eklem protezi; Perioperative bakım; Risk faktörleri
Citation
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