Factors associated with complex surgical wounds in breast and abdomen: a case-control observational study

Abstract

Objective:to identify factors associated with complex surgical wounds in the breasts and abdomen in outpatients. Method:observational case-control study involving 327 patients, distributed into 160 cases (complex surgical wound) and 167 controls (simple surgical wound). Data were extracted from the medical records and a binary logistic regression model was used for analysis, considering a significance level of 5%. Results:the factors associated with greater chance of occurrence of complex surgical wound were 18 to 59 years of age (p = 0.003), schooling < 8 years (p = 0.049), radiotherapy (p < 0.001), hysterectomy (p = 0.003), glycemia (≤ 99 mg/dL) and arterial hypertension (p = 0.033), while quadrantectomy (p = 0.025) served as a protective factor. Conclusion:radiotherapy was the most significant factor for surgical wound complications. Glycemic alteration was an unexpected result and shows the need for further studies related to this topic.

Prevalence of complicated surgical wounds and related factors among adults hospitalized in public hospitals

“…This study found that the male gender represented 8.2 times higher chances of complications for patients in general hospitalization with ecchymosis -a fact Fusco et al (28) also report -, constituting a four-fold higher risk of infection (p = 0.005), which a study conducted in patients undergoing orthopedic surgery (15) also corroborates. However, this finding disagrees with other studies which found no association between surgical wound complication and gender (11,16,23) or, conversely, in which the highest complication rate occurred in women (9,29) . Thus, it remains a controversial factor that may be considered a confounding variable that depends on both the demographic profile of the assessed health institution and on surgical pathology gender disparities.…”

“…The literature reports several risk factors associated with the development of surgical wound complications, among which are patients' systemic conditions, such as age, nutritional status, medication use, uncontrolled comorbidities, and habits such as smoking, which negatively affect healing (9) . Another category includes factors related to the surgical procedure, such as duration, closure techniques, hygiene and asepsis protocols, drain use, contamination degree, and emergency condition, among others (7,10) .…”

“…It may even compromise surgery outcomes and entail further interventions. Thus, prevention and early detection are essential (5)(6)(7)(8)(9)(10)12,17) .…”

Incidência e fatores associados a complicações em feridas operatórias de mulheres mastectomizadas

“…Embora o presente estudo não tenha identificado a associação entre as variáveis de exposição e a incidência de deiscência de ferida operatória, a mesma apresentou taxa de incidência de 4,21/100 mastectomias-dia o que corrobora com estudos, que apresentaram incidência de 2,1% em mastectomia 35 e entre 7,2% a 10% em mastectomias com reconstrução 10,35 . Entre os fatores de risco para ocorrência de deiscência destacam-se infecção local 18 , estresse excessivo nas bordas da ferida 18 , hipoperfusão da área 18 , radioterapia neoadjuvante 36 , idade avançada 18 e realização da cirurgia de emergência 18 .…”

“…Dentre estes, destacam-se: infecção local, deficiência da técnica cirúrgica, tensão excessiva das bordas da ferida, baixa perfusão nesta área, processo traumático na ferida no pós-operatório, radioterapia e cirurgia de emergência. Com relação aos fatores sistêmicos, mencionam-se idade, desnutrição, obesidade, tabagismo, comprometimento imunológico, uso crônico de medicamentos esteroidais ou imunoterápicos 18 . Desse modo, a determinação dos fatores que afetam o processo de cicatrização das feridas operatórias é fundamental para a realização de medidas de prevenção de complicações e tratamento das mesmas.…”