Infecção de sítio cirúrgico em hospital universitário: vigilância pós-alta e fatores de risco

Abstract

Objetivou-se determinar a incidência da Infecção do Sítio Cirúrgico (ISC) em pacientes submetidos à cirurgia do aparelho digestivo (CAD), durante a internação e após alta, verificar a ocorrência de associação entre a ISC e o tipo de cirurgia, tempo de internação, condição clínica do paciente, classificação e duração da cirurgia. Tratou-se de um estudo prospectivo e descritivo realizado em um hospital universitário de agosto de 2001 a março de 2002. De 357 pacientes sub-metidos à CAD, 64 ISC foram notificados, 16 na internação e 48 pós-alta, incidência de 4,5% e 13,9%, respectivamente. Verificou-se uma associação da ISC com o tempo de internação pré-operatório e a classificação da ferida operatória. A taxa global da ISC foi de 18,0%. Observou-se um aumento da ISC em quatro vezes quando a vigilância pós-alta foi realizada. Chama atenção que, caso a vigilância pós-alta não fosse realizada, a taxa global da ISC seria fortemente subnotificada.

Surgical site infection and its risk factors in colon surgeries

“…In a national prospective study conducted in a university hospital, of 357 patients undergoing surgery of the digestive tract, were reported 64 SSI cases, of which 16 occurred during hospitalization, and 40 after discharge, resulting in incidences of 4.5% and 13.9%, respectively (10) . In another prospective study in two teaching hospitals, 501 patients underwent gastrointestinal surgery, and 140 SSI cases were diagnosed, of which, 31 reported during hospitalization and 109 during post-discharge, with incidence rates of 6.2% and 28%, respectively (11) .…”

“…In the literature, the SSI rates in colon surgery varied from 3.5 to 21.3%, and are pointed as the largest SSI rates among elective procedures (5)(6)(7)(8)(9)(10)(11) . But diagnosing SSI only during hospital stay has not provided actual rates, which may underestimate the real values, as shown in a national study that notified 75% of SSI during post-discharge surveillance (10) .…”

“…But diagnosing SSI only during hospital stay has not provided actual rates, which may underestimate the real values, as shown in a national study that notified 75% of SSI during post-discharge surveillance (10) .…”

“…For the factors related to the surgical procedure, the most prevalent were: long surgeries (time > 240 min), surgery classification according to the potential for contamination and open surgical approach (5)(6)(7)(8)(9)(10) .…”

Pré-operatório de cirurgias potencialmente contaminadas: fatores de risco para infecção do sítio cirúrgico

“…However, many hospitals monitor surgical patients only during hospitalization, but the possibility of infection after hospital discharge cannot be discarded. (31) In this study, there was SSI in the postoperative period at home given the aspects and characteristics of this infection reported by patients and/or family members at the time of the telephone interview. In a different study, 12% to 84% of SSI were diagnosed in the post-discharge period, while in another study 25% of SSI were identified in the hospital setting and 75% at home.…”