Analysis of the treatment protocol for sternotomy wound infection after cardiac
            surgery

Gallafrio, Samuel Terra; Menezes, Thomaz; Filho, Franklin Monaco; Alvarez, Damaris; Strabelli, Tânia Mara Varejão; Jatene, Fábio Biscegli; Gemperli, Rolf

doi:10.5935/2177-1235.2017rbcp0031

Cited by 5 publications

(9 citation statements)

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“…This treatment tends to be more painful than only antibiotic therapy because of increased invasiveness and the need for debridement of the surgical incision [7,8] . However, the treatment used in our sample decreased significantly the overall mortality and the rates of recurrence and readmission [15] .…”

Section: Discussionmentioning

confidence: 62%

“…Adipose tissue is susceptible to the microbial colonization and proliferation. Several studies reported that patients who smoke, in particular those with chronic obstructive pulmonary disease, are vulnerable to surgical wound infections [15] due lower lung capacity, which impairs tissue oxygenation [2,5] . Even though our study exclude chronic pulmonary disease, the effect of active smoking on sternal healing should not be dismissed [3] .…”

Section: Discussionmentioning

confidence: 99%

“…Surgical wound infection is a severe postoperative complication and leads to prolonged in-hospital stay, increased hospital costs, and high rates of patient morbidity and mortality [15] . Regarding the microorganisms identified in cultures of the surgical wounds, the incidence of S. aureus both in ARM (40%) and LEG (60%) was higher than that of other microbial agents, which confirms the results reported in the literature [6,7] .…”

Section: Discussionmentioning

confidence: 99%

“…All of the participants signed the informed consent. Patients with wound infection/mediastinitis after sternotomy present a long time of hospitalization in our service, in most cases, more than 15 days with antibiotics and extensive surgical debridement of surgical wound, treatment with negative pressure therapy, and closure of the wound with myocutaneous or fasciocutaneous flaps according to the protocol developed by the InCor/HC-FMUSP [15] . All patients who participated in the study used VAC and finalized the intra-hospital protocol.…”

Section: Objectivementioning

confidence: 99%

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Infra-Abdominal Muscles Activation Brings Benefits to the Pulmonary Function of Patients with Sternal Instability after Cardiac Surgery

Nozawa¹,

Gonçalves²,

Almeida³

et al. 2020

Braz J Cardiovasc Surg

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Objective: To compare physical therapy strategies involving abdominal muscle stabilization, with and without upper limb movement, in patients with sternal instability after heart surgery and during in-hospital care.Methods: This prospective, longitudinal, randomized, and comparative clinical study included 20 patients, which were divided into two groups: ARM, the arm group (n=10), and LEG, the leg group (n=10). The study involved the evaluation of scores of visual analog scales for sternal instability, pain, discomfort, functional impairment, lung function, and maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) before and after the interventions. Two protocols consisting of abdominal exercises in both groups with upper limb movements (ARM) and just abdominal activation with leg movements (LEG) were used for three weeks.Results: There were statistically significant (P≤0.01) improvements in pain, discomfort, and functional impairment scores, and in MIP (P=0.04) and MEP (P≤0.01) after intervention in both groups and just LEG showed improvement in forced vital capacity (P=0.043) and forced expiratory volume in one second (P=0.011).Conclusion: Both strategies promoted improvement in pain, discomfort, and functional impairment scores and in the values of inspiratory and expiratory pressures. Perhaps they were influenced by the time and resolution of the infection process, although exercises with upper limb movements seem to be safe in this population. The activation of the infra-abdominal muscles through leg movements seems to bring more benefits to lung function.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Objectivementioning

confidence: 99%

See 2 more Smart Citations

Infra-Abdominal Muscles Activation Brings Benefits to the Pulmonary Function of Patients with Sternal Instability after Cardiac Surgery

Nozawa¹,

Gonçalves²,

Almeida³

et al. 2020

Braz J Cardiovasc Surg

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“…Strategies for the prevention and treatment of SSIs have been frequently discussed, especially those targeted at populations at risk, such as elder patients and those with chronic an critical diseases. Many resources and therapies for the dressing of surgical wounds (SW) are commercially available, and have often been successful when associated to assistance protocols developed and standardized by health teams, together with the professionals which act in the control of hospital infections (HIC) (8)(9) .…”

Section: Introductionmentioning

confidence: 99%

Cenário ambulatorial de pacientes com sítio cirúrgico infectado após intervenção cardíaca

Kahl

Brião

Costa

et al. 2019

Rev. Gaúcha Enferm.

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Resumo OBJETIVO Verificar o perfil clínico-cirúrgico e os resultados de pacientes acompanhados em um ambulatório de ferida operatória após cirurgia cardíaca. MÉTODOS Coorte histórica com pacientes submetidos à cirurgia cardíaca e acompanhados por um ano em um ambulatório de feridas de um hospital especializado em cardiologia. Foram analisados os micro-organismos predominantes nas infecções, os produtos utilizados nos curativos, tempo de acompanhamento e o tipo de terapêutica instituída nos curativos. RESULTADOS Entre os 150 pacientes, predominaram sexagenários (61,7 ± 11,4 anos), hipertensos (75%), diabéticos (44,7%). Evidenciou-se 12 pacientes com mediastinite (8%) e 44 com infecção de sítio cirúrgico (29,3%). Utilizou-se para realização dos curativos os ácidos graxos (80%) e alginato de cálcio (19%). O tempo de acompanhamento foi de 35 ±71 dias. CONCLUSÃO Pacientes sexagenários, hipertensos, diabéticos e revascularizados constituíram a população acompanhada no ambulatório de feridas. As taxas de ISC e mediastinite encontradas foram aceitáveis e semelhantes às da literatura.

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Prognostic Indicators of Delayed Surgical Recovery in Patients Undergoing Cardiac Surgery

Carmo

Santana

Lopes

et al. 2021

J of Nursing Scholarship

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Purpose The purpose of this study was to analyze the prognostic capacity of the clinical indicators of a delayed surgical recovery nursing diagnosis throughout the hospital stay of patients having cardiac surgery. Design A prospective cohort design was adopted. A sample of inpatients undergoing elective cardiac surgery was followed during the immediate preoperative period and hospitalization. This research was conducted in the southeast region of Brazil at a national reference institution that treats highly complex diseases and performs cardiac surgeries. Data were collected from July 2017 to July 2018. Methods At the end of 1 year of data collection, 181 patients were followed in this study. The Kaplan‐Meier method was used to calculate the survival time related to delayed surgical recovery. In addition, an extended Cox model of time‐dependent covariates was adjusted to identify the clinical signs that influenced the change in the nursing diagnosis status. Results A delayed surgical recovery nursing diagnosis was present in 23.2% of the sample studied. With an expected length of stay of 8 to 10 days, most new cases of delayed surgical recovery were observed on the 10th postoperative day, and the survival rate after this day was decreased until the 29th postoperative day, when the nursing diagnosis no longer appeared. Interrupted healing of the surgical area, loss of appetite, and atrial flutter were indicators related to an increased risk for delayed surgical recovery. Conclusions Timely recognition of selected clinical indicators demonstrates a promising prognostic capacity for delayed surgical recovery. Clinical Relevance Accurate identification of prognostic factors allows nurses to identify early signs of postoperative complications. Consequently, the professional can develop an individualized plan of care, aiming at the satisfactory clinical recovery of the patient.

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Analysis of the treatment protocol for sternotomy wound infection after cardiac surgery

Cited by 5 publications

References 0 publications

Infra-Abdominal Muscles Activation Brings Benefits to the Pulmonary Function of Patients with Sternal Instability after Cardiac Surgery

Infra-Abdominal Muscles Activation Brings Benefits to the Pulmonary Function of Patients with Sternal Instability after Cardiac Surgery

Cenário ambulatorial de pacientes com sítio cirúrgico infectado após intervenção cardíaca

Prognostic Indicators of Delayed Surgical Recovery in Patients Undergoing Cardiac Surgery

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