Does using Jackson-Pratt drain affect the incidence of sternal wound complications after open cardiac surgery?

Abstract

Background: This study aims to investigate the effect of the Jackson-Pratt drain on sternal wound complications in patients with a Body Mass Index of ≥30 kg/m 2 undergoing open cardiac surgery via median sternotomy. Methods: A total of 174 patients (124 males, 50 females; mean age 58.2±10.4 years; range, 33 to 78 years) with a Body Mass Index of ≥30 kg/m 2 undergoing cardiac surgery via median sternotomy between January 2011 and December 2015 in our institution were retrospectively analyzed. Of the patients, 94 were inserted a Jackson-Pratt drain (JP group) following median sternotomy, while 80 patients received no drain (non-JP group). Pre-, intra, and postoperative outcomes of both groups including type of operation, length of hospital stay, and complications were compared. Results: No significant difference in the age, gender, Body Mass Index, and potential risk factors was found between the groups. The median of stay in the intensive care unit was two days and the median time from operation to discharge was seven days in both groups. There was a statistically significant difference in the rate of sternal wound complications between the groups. Sternal wound complications occurred in two patients (2.1%) in the drained group, compared to nine patients (11.25%) in the non-drained group (p=0.01). Conclusion: Our study results show that Jackson-Pratt drain insertion after median sternotomy in patients with a Body Mass Index of ≥30 kg/m 2 undergoing open cardiac surgery is a simple and reliable method to reduce the risk of postoperative sternal wound complications, compared to the conventional closure technique. © 2019 All right reserved by the Turkish Society of Cardiovascular Surgery.; Amaç: Bu çalişmada median sternotomi ile açik kalp cerrahisi yapilan, Vücut Kütle I˙ndeksi ≥30 kg/m 2 olan hastalarda Jackson- Pratt dreninin sternal yara komplikasyonlari üzerindeki etkisi incelendi. çalişma plani: Ocak 2011-Aralik 2015 tarihleri arasinda Vücut Kütle I˙ndeksi ≥30 kg/m 2 olan, hastanemizde median sternotomi ile açik kalp cerrahisi yapilan toplam 174 hasta (124 erkek, 50 kadin; ort. yaş 58.2±10.4 yil; dağilim, 33-78 yil) retrospektif olarak incelendi. Hastalarin 94'üne median sternotomi sonrasi Jackson-Pratt dreni takilirken (JP grubu), 80 hastaya dren takilmadi (JP olmayan grup). Her iki grubun ameliyat tipi, hastanede kaliş süresi ve komplikasyonlar dahil olmak üzere ameliyat öncesi, sirasi ve sonrasi sonuçlari karşilaştirildi. Bulgular: Gruplar arasinda yaş, cinsiyet, Vücut Kütle I˙ndeksi ve muhtemel risk faktörleri arasinda anlamli bir fark yoktu. Her iki grupta da yoğun bakim ünitesinde median kaliş süresi iki gün ve ameliyattan taburculuğa kadar geçen median süre yedi gündü. Gruplar arasinda sternal yara komplikasyon orani açisindan istatistiksel olarak anlamli bir fark bulundu. Dren takilmayan grupta dokuz hastaya (%11.25) kiyasla, dren takilan grupta iki hastada (%2.1) sternal yara komplikasyonu gelişti (p=0.01). Sonuç: çalişma bulgularimiz, median sternotomi sonrasinda Jackson-Pratt dren kullaniminin vücut kitle indeksi ≥30 kg/m 2 olan, açik kalp cerrahisi yapilan hastalarda geleneksel kapatma tekniğine kiyasla, ameliyat sonrasi sternal yara komplikasyon riskini azaltmada basit ve güvenli bir yöntem olduğunu göstermektedir. © 2019 All right reserved by the Turkish Society of Cardiovascular Surgery.