Secondary hyperparathyroidism is the hyperplasia and hyperfunctioning of the parathyroid gland in chronic renal failure. The aim of our study was to evaluate the efficiency and complications of surgical methods for secondary hyperparathyroidism in patients requiring dialysis. Forty-one patients operated for secondary hyperparathyroidism before renal transplantation were retrospectively analysed. The efficiency and complications of types of surgery in relation with age, gender, duration of dialysis, symptoms, laboratory test results before and after surgery were evaluated. Mean duration of dialysis was 6.2 ± 3.98 years. Patient's calcium, phosphorus and parathormone levels before surgery were 9.83 ± 1.25 mg/dl, 5.73 ± 2.15 mg/dl, 1847, 0.02 ± 666.602 pg/ml and, after surgery, were 7.85 ± 1.36 mg/dl, 4.5 ± 1.55 mg/dl, 288.05 ± 404.09 pg/ml. The differences betweeen preoperative and postoperative values were statistically significant (p < 0.05) recognizing the efficiency of surgery. The age of patients, the duration of dialysis and the type of surgery were not significantly effective on this difference (p > 0.05). Fifteen patients had subtotal parathyroidectomy, 25 patients had total parathyroidectomy with autotransplantation and one patient had total parathyroidectomy. The incidence of complications did not differ with age, gender, duration of dialysis and type of surgery (p > 0.05). The type of surgery did not possess difference in the improvement in levels of calcium, phosphorus and parathormone and also in the incidence of complications in secondary hyperparathyroidism. Surgeon's experience and individual patient characteristics seem to be more important in determining the type of surgery.

ÖZETAmaç: Cerrahi alan infeksiyonları (CAİ) cerrahiden sonra görülen major bir problemdir. Hasta konforunun bozulmasına, morbidite ve mortalite artışa, hastanede kalış sü-resinin uzamasına ve hastane maliyetlerinde artışa neden olurlar. Bu çalışmanın amacı cerrahi alan infeksiyonlarını etkileyen risk faktörlerini araştırmaktır. Materyal ve Metod: Bir devlet hastanesinde Kasım 2007ile Ağustos 2009 tarihleri arasında cerrahi uygulanan 1040 hasta; CAİ ve onunla ilişkili yaş, cinsiyet, ASA derecelendirmesi, anestezi tipi, cerrahinin zamanlaması ve böl-gesi, yara tipi ve altta yatan hastalık açısından retrospektif olarak incelendi. Bulgular:Hastaların yaşları 4 ile 82 yıl (ort. 36,1 ±15,8 yıl) arasında ve kadın/erkek oranı 43/57 idi. 1040 hastanın 53'ünde (% 5,1) CAİ tanısı konmuştu. CAİ gelişen vakaların % 39,2'sinde S. aureus izole edildi. CAİ gelişen hastaların ortalama yatış süresi 7 gün iken, gelişmeyen hastalarda bu oran 2,7 gün idi. Yaş, yara tipi, ASA skoru ve altta hastalıkla CAİ gelişmesi arasında anlamlı fark bulundu (p<0,05). Sonuç:Hastaların ameliyat sonrası CAİ oranları literatür ile uyumlu idi. Hastanın yaşı, ASA skoru, yara tipi ve ek hastalık varlığı faktörleri değiştirilmez. Ancak CAİ için risk ameliyat öncesi antibiyotik profilaksisi ile azaltılabilir.Anahtar Kelimeler: Cerrahi alan infeksiyonu, insidans, risk faktörleri. ABSTRACTObjective: Surgical site infections (SSIs) are a major problem after surgery. They cause to impairment of patient comfort, increase morbidity, mortality, in hospital stay and costs. The aim of this study is to investigate the risk factors affecting SSIs. Results: Patients ranged in age from 4 to 82 years (mean 36,1 ±15,8) and female to male ratio was 43/ 57. Of 1040 patients, 53 (5,1 %) had a diagnosis of SSI. The isolated pathogen in the 39,2 % of the patients who developed wound infection was S. aureus. The hospital stay was average 7 days in the patients developed SSI while it was 2,7 days in the patients without SSI. The age, wound type, ASA scores and underlying diseases were found significant in the development of SSIs (p<0,05). Material and Methods Conclusions:Postoperative wound infection rates in our patients were in compatible with literature. Patient's age, ASA score, wound type and the presence of additional disease are not changed factors but this risk can be reduced in patients with preoperative antibiotic prophylaxis.