Infección de sitio quirúrgico en un servicio de cirugía general. Análisis de cinco años y valoración del índice National Nosocomial Infection Surveillance (NNIS)

Iñigo, José; Bermejo, Begoña; Oronoz, Begoña; Herrera, Javier; Tarifa, Antonio; Pérez, Felicidad; Miranda, Coro; Lera, José Miguel

doi:10.1016/s0009-739x(06)70857-0

Cited by 25 publications

(2 citation statements)

References 19 publications

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“…We describe the association between type of surgery, ASA level and the presence of infection in the postoperative period, describing a rate of infection in the surgical suite and validating the risk stratification of the National Nosocomial Infection Surveillance Index (NNIS) and the influence of each factor. The duration of the intervention, specifically, is considered the factor that most influences infection rates, and ASA level the least [27]. In our study, the duration of the procedure was similar in all women, so this factor cannot be evaluated.…”

Section: Functional Recovery and Complicationsmentioning

confidence: 81%

“…Although infection is a greatly feared complication, it has obvious symptoms and signs, so treatment and management are very similar in all patients and dispersion is therefore very low. ASA risk is one of the items that least influences the number of infections, according to several studies [27]. There are similar studies where the incidence of infection is also not high, although certain factors are associated with an increased risk of infection.…”

Section: Time To Functional Recoverymentioning

confidence: 91%

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The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Cisneros-Pérez

Yusta-Martín

Sánchez-Conde

et al. 2020

JCM

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Introduction: Stress urinary incontinence (SUI) has an incidence of 15–80% in women. One of the most widely used surgical techniques for treatment is the placement of a suburethral transobturator tape (TOT). Although this technique has a relatively low morbidity rate, it is not exempt from intraoperative or postoperative complications, which can have an impact on functional recovery, understood as the return to routine life prior to the intervention. Aims: To assess the time for functional recovery in women operated on for SUI by TOT; to identify complications and related factors, according to anaesthetic risk, which condition the time to functional recovery; and proposals for improvements in the prevention of possible complications and in reducing functional recovery time. Materials and methods: A non-concurrent prospective observational multicenter study of 891 women undergoing TOT for stress urinary incontinence since 1 April 2003, who were successful in achieving urinary continence (completely dry). Study groups: GA (n = 443): patients with ASA I risk. GB (n = 306): patients with ASA II risk. GC (n = 142): patients with anaesthetic risk ASA III. Investigated variables: age, body mass index, follow-up time, secondary diagnoses, surgical history, obstetric-gynecological history, toxic habits, and complications derived from surgery: bleeding, pain, infection. Descriptive statistics, Student’s t test, Chi2, Fisher, ANOVA, multivariate analysis, significance for p < 0.05. Results: Mean age was 60.10 years (SD13.38), with no difference between groups. Mean body mass index (BMI) was 26.55 kg/m2 (SD 4.51), lowest in GA. GB had more HT (38.6%) than GC (23.23%), more type 2 diabetes (19.83% versus 10.56%), and more respiratory disorders (6.97% versus 2.11%). There were more women with anxiety in GB (19.3%) than in GC (6.33%) (p = 0.0221) and GA (10.51%) (p = 0.0004). There was more hypothyroidism in GB (16.08%) compared to GC (2.11%) and GA (9.07%). There was more history of curettage in GC (11.97%) versus GB (5.63%); and more pelvic surgery in GB (71.31%) and GC (66.9%) compared to GA (32.57%). There were more concomitant treatments with benzodiazepines in GC (27.46%) and GB (28.41%) than in GA (8.86%), and more parapharmacy treatments in GB (17.96%) than in GC (6.33%). Following the operation, 113 patients had some sign or symptom that required medical attention: in GA 48 (10.83%), in GB 49 (16.06%), in GC 16 (13.22%). Mean days until functional recovery in patients with complications: in GA 5.72 (SD2.05); bleeding 3 (SD1), pain 6.40 (SD1.34), and infection 7.33 (SD0.57), with fewer days for bleeding than for pain or infection. GB: 27.96 (SD 28.42), bleeding 3 (SD0), pain 46.69 (SD31.36), infection 10.83 (SD3.90); lowest for patients with bleeding. GC: 9.44 (SD 2.50); for bleeding 7.66 (SD2. 08), pain 10.66 (SD1.15), infection 10 (SD3.46); no differences. Overall, for women with bleeding, the time was 4.16 days (SD1.94); less in GA and GB than in GC. Pain, at 31.33 days (SD 30.70), was the factor that most delayed functional recovery; in GB women, it took longer to return to work due to pain (45.96, SD31.36) compared to GA (6.4, SD 1.34) and GC (10.66, SD1.15). In women with infection, overall mean time was 10.11 days (SD 3.61) with no difference between groups. Conclusions: Mean time for the return to normal activity in patients who underwent TOT for SUI is 5 days if there are no complications, and 16.91 days if there are any. The ASA-SP risk group classification can be used to anticipate functional outcomes. An ASA-PS risk-based functional recovery forecasting protocol should be adapted, especially ASA II patients who may present with long-term disabling postoperative pain. Preventive management measures are proposed that favour functional recovery.

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Section: Functional Recovery and Complicationsmentioning

confidence: 81%

Section: Time To Functional Recoverymentioning

confidence: 91%

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Cisneros-Pérez

Yusta-Martín

Sánchez-Conde

et al. 2020

JCM

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Surgery for Body Packing in the Caribbean: A Retrospective Study of 70 Patients

et al. 2007

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Bowel obstruction and symptoms of intoxication are clear indications for surgery in body packing patients. In our study there was a low mortality and stoma placement rate, we did find a remarkable high amount of wound infection but no evidence for a higher incidence of fascia dehiscence in comparison with elective gastrointestinal surgery. In surgery for bodypacking a mandatory postoperative x-ray is indicated. A prospective trial is needed to assess more information about possible predictive factors of postoperative complications and mortality after surgery for body packing.

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Subcuticular Absorbable Suture with Subcutaneous Drainage System Prevents Incisional SSI after Hepatectomy for Hepatocellular Carcinoma

et al. 2012

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Infección de sitio quirúrgico en un servicio de cirugía general. Análisis de cinco años y valoración del índice National Nosocomial Infection Surveillance (NNIS)

Cited by 25 publications

References 19 publications

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

The American Society of Anesthesiologists Physical Status (ASA-PS) Risk Group Classification Can Be Used to Anticipate Functional Recovery Outcomes after the Surgical Treatment of Female Urinary Incontinence with Transobturator Suburethral Tape

Surgery for Body Packing in the Caribbean: A Retrospective Study of 70 Patients

Subcuticular Absorbable Suture with Subcutaneous Drainage System Prevents Incisional SSI after Hepatectomy for Hepatocellular Carcinoma

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