Neste estudo exploratório, descritivo e de coorte o objetivo principal foi verificar a incidência de pacientes submetidos à cirurgia cardíaca que desenvolveram lesões de pele no período intra-operatório, caracterizar as lesões. A coleta de dados foi realizada no Centro Cirúrgico (CC) de um hospital público de ensino, de atenção terciária à saúde, predominantemente cirúrgico, especializado em cardiologia no Município de São Paulo. A amostra do estudo foi de 182 pacientes. O estudo foi feito com um p significativo (<0,05) frente aos testes estatísticos não-paramétricos. Quanto à incidência de pacientes submetidos à cirurgia cardíaca, que desenvolveram lesões de pele em decorrência do período intra-operatório, obteve-se incidência de 20,9%. Tivemos que 19,2% das lesões apresentaram-se como Úlceras por Pressão (UP) no estágio I; 1,1% das lesões caracterizaram-se como abrasão; 1,1% feridas incisas; 0,5% laceração; 0,5% queimadura elétrica superficial e 0,5% UP no estágio II.
The maintenance of skin integrity is an individual care given to each patient that is integrated to other intraoperative cares, applying both technical and scientific knowledge. Nursing care provided to the patient in the intraoperative stage will reflect in the post-operative one 3. Many skin lesions start in the operating room and worsen in the post-operative stage 22. This research is justified by the scarceness of studies referring to skin lesions on patients that developed and were observed during the intraoperative stage. In this exploratory, descriptive and cohort study, the main objective was to verify the incidence of patients that underwent heart surgery who developed skin lesion in the intraoperative stage, to characterize lesions and to identify risk factors. The collection of data occurred in an Operating Room (OR) of a public teaching hospital, with tertiary health care, predominantly surgical, and specialized in cardiology in the Municipality of São Paulo, and the study sample was taken from 182 patients. The study was performed with a significant p (≤ 0,05) compared to the non-parametric statistics tests. Most of the patients studied were females (67%), with an average age of 63 year (53-70). Caucasians were predominant (63,2%). Patients had a BMI medium of 26,15 (23,3-29) and the average of hospitalization days was 6 (2-11). As for the patients clinical profile 49,5% presented heart failure, 18,7% mitral valve failure; 83,5% of the patients presented high blood pressure, 22,5% had non-insulin dependent diabetes and 9,3% had insulin dependent diabetes; 20,9 used alcoholic beverages and 13,2 were smokers. Concerning the clinical skin evaluation, we found a predominance of light pink skin coloration in 76,4%, 56% normal texture, 67% normal turgor, and 61,5% of the patients had normal skin moister. As for the incidence of patients that underwent heart surgery, which developed skin lesions due to the intraoperative stage, an incidence of 20,9% was obtained.(38). We found that 35 (19,2%) lesions presented Stage I PU, 02 (1,1%), lesions were characterized as abrasions, 02 (1,1%) incise wounds, 01 (0,5%) laceration, 01(0,5%) superficial electric burn and 01(0,5%) Stage II PU. As for risk factors for skin lesions in the intraoperative stage of heart surgery, during the statistics analysis, considering p< 0,05, showed as statistically significant: the increased age (63 years) p= 0,053; the presentation of pale skin p= 0,015; normal skin moister of p= 0,042; the total time of the anesthesia procedure with p= 0,035. Patients that used Esophagic Trans Echo equipment had statistical significance with p= 0,031, e the ones that used the External Defibrillator equipment p= 0,01. The integrity of the skin referring to PUs prevention has been well studied however there are still few works about skin lesions. The surgery patient is followed by risk factors that cooperate with the development of lesions; hence perioperative nursing must be aware of all risks to elaborate an individual care and assistance plan for pat...
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