Objective: To analyze the occurrence and risk factors for surgical site infection in patients undergoing orthopedic surgery. Methods: A prospective cross-sectional study with 93 patients undergoing elective and clean orthopedic surgery. Results: The surgical site infection was diagnosed in 16 patients (17.2%). In data analysis, after adjusting the binary logistic regression model, only the variable total time of hospitalization was statistically significant with respect to the presence or absence of infection. Conclusion: The occurrence of surgical site infection in orthopedic surgery was higher, with 75% of cases diagnosed after hospital discharge, this result reinforces the need for post-discharge surveillance. ResumoObjetivo: Analisar a ocorrência e os fatores de risco para infecção de sítio cirúrgico em pacientes submetidos a cirurgias ortopédicas. Métodos: Estudo transversal prospectivo com 93 pacientes submetidos a cirurgias ortopédicas eletivas e limpas. Resultados: A infecção de sítio cirúrgico foi diagnosticada em 16 pacientes (17,2%). Na análise dos dados, após ajuste do modelo de regressão logística binária, apenas a variável tempo total de internação mostrou-se com relação estatisticamente significativa com a presença ou não de infecção. Conclusão: A ocorrência de infecção de sítio cirúrgico em cirurgia ortopédica foi mais elevada, sendo 75% dos casos diagnosticados após a alta hospitalar, resultado que reforça a necessidade da vigilância pós-alta.

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Objective: To analyze risk factors for surgery site infection in neurosurgery. Methods: A prospective cross-sectional study conducted in a tertiary hospital analyzing 85 elective and clean neurosurgeries with an outcome of infection within 30 days after surgery. Results: Surgical site infection occurred in 9.4% (n=8) of cases. Bivariate analysis revealed that the following risk factors were associated with the presence of infection: total length of hospital stay, Body Mass Index, surgical size and blood transfusion. After running binary logistic regression adjustments, only the total length of hospital stay was significantly related to the presence of infection. Conclusion: The occurrence of surgical site infection in neurosurgery in the studied institution was higher than recommended by the scientific literature. The results show that outpatient follow up of patients who undergo surgery after hospital discharge may reduce the underreporting of infection cases. ResumoObjetivo: Analisar os fatores de risco de infecção da ferida operatória em neurocirurgia. Métodos: Estudo transversal, prospectivo, conduzido em hospital de nível terciário com 85 neurocirurgias eletivas e limpas, tendo como desfecho a infecção até 30 dias após o procedimento cirúrgico. Resultados: A ocorrência de infecção de sítio cirúrgico foi de 9,4% (n=8). Na análise bivariada observou-se que os fatores de risco: tempo total de internação, Índice de Massa Corporal, porte cirúrgico e transfusão sanguínea foram associados com a presença de infecção. Após ajuste no modelo de regressão logística binária, apenas o tempo total de internação mostrou relação estatisticamente significativa com a presença de infecção. Conclusão: A ocorrência de infecção de sítio cirúrgico em neurocirurgia na instituição estudada foi maior do que o preconizado na literatura científica. Os resultados apontaram que o acompanhamento ambulatorial do paciente cirúrgico após a alta hospitalar pode reduzir a subnotificação dos casos de infecção.

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Controle glicêmico no perioperatório: evidências para a prevenção de infecção de sítio cirúrgico ABSTRACTThe objective of the present study was to analyze the evidence available in literature regarding blood glucose control to prevent surgical site infection in the perioperative period. The integrative literature review was the chosen review method.The primary studies were searched on the following databases: Medline, CINAHL, EMBASE and LILACS. Of the 26 primary studies included in the review, 12 were conduced with diabetes patients and 14 were performed with patients with and without diabetes; results showed a reduction in surgical site infection rates, mortality, and length of stay, when blood glucose is practiced. Nevertheless, due to the different outlines of the studied included, the investigated sample, type of surgery, blood glucose control parameters and methods, it is concluded that evidence is still insufficient to delimit the best level of target blood glucose and the ideal diet for blood glucose in the perioperative period.Descriptors: Perioperative Nursing; Surgical Wound Infection; Glycemic Index. RESUMENSe objetivó analizar las evidencias disponibles en la literatura sobre control glucémico para prevención de infección del sitio quirúrgico en el perioperatorio. Se adoptó el método de revisión integrativa de literatura. Para localización de los estudios primarios, se seleccionaron las siguientes bases de datos: Medline, CINAHL, EMBASE y LILACS, De los 26 estudios primarios incluidos en la revisión, 12 fueron realizados con muestra de pacientes diabéticos y 14 con pacientes con y sin diabetes; los resultados expresaron reducción en la tasa de infección del sitio quirúrgico, mortalidad y tiempo de internación hospitalaria, cuando se realizó control glucémico. Mientras tanto, en razón de diferencias en el diseño de los estudios incluidos, muestra investigada, tipo de cirugía, parámetros y métodos de control glucémico, se concluye que aún no existen evidencias suficientes como para delimitar el mejor nivel de glucosa-blanco y el régimen ideal para el control glucémico en el perioperatorio.

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Aim: To estimate the incidence rates of surgical site infection and identify the independent effect of perioperative hypothermia on the incidence of this type of infection in patients undergoing abdominal surgery.Background: Around the world, surgical site infection is a frequent complication in surgical patients, mainly causing increased morbidity and mortality rates and health service costs.Design: A prospective cohort study. Methods:The 484 patients were recruited from a large private philanthropic hospital in the state of São Paulo, Brazil, from July 2016 to May 2017. Crude and adjusted models were constructed for the hypothermia indicators to assess the effect of this exposure on surgical site infection. Results:The incidence rate of surgical site infection was 20.25% (n = 98). The attributable fraction to exposed to hypothermia was >40%. A greater probability of developing surgical site infection (relative risk = 1.89) was found for patients who experienced body temperatures <36.0 C (from entry time into the operating room until the end of the surgery) for more than five hypothermic episodes or longer than 75 min. Conclusion:Perioperative hypothermia was an independent risk factor for surgical site infection. Summary statementWhat is already known about this topic?• Around the world, surgical site infection is a complication that leads to damage to the patient and increased costs for the health services. Despite recent advances in surgical techniques, surgical site infection remains one of the most frequent complications in abdominal surgery.• Perioperative hypothermia can increase the incidence rates of surgical site infection.• There is evidence that perioperative hypothermia is associated with surgical site infection in abdominal surgery, but most studies were conducted in developed countries using retrospective designs.