Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Gamo, Gustavo de Oliveira; Reichardt, Gabriel Sebben; Guetter, Camila Roginski; Pimentel, Silvânia Klug

doi:10.1590/0102-672020220002e1675

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Para realizar un procedimiento quirúrgico es necesario determinar si el paciente está en condiciones óptimas para ser interviniendo quirúrgicamente, estos indicadores se mantienen durante todo el proceso peri operatorio con el objetivo de realizar una cirugía segura y evitar complicaciones (Macías,2022), los parámetros que se evalúan son tiempo de ingreso, realización de profilaxis antimicrobianas 24 horas antes o por los menos 30 a 60 minutos antes de la incisión, para maximizar la concentración de antibióticos en los tejidos, realización del procedimiento de antisepsia del campo operatorio y control del nivel de glucemia postoperatoria en los pacientes que tengan diabetes siendo esto un factor de riesgo (Gamo et al, 2022;Guo et al,2022). ISSN en línea: 2789-3855, marzo, 2023, Volumen 4, Número 1, p. 2586.…”

Section: Resultsunclassified

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

Chicaiza¹,

Guaita²,

Ocaña³

et al. 2023

LATAM

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La infección post quirúrgica en el sitio de incisión, se manifiesta por la aparición de una serie de microorganismos como staphilococcus aureus, enterococos, escherichia coli, entre otros. Es por ello, que el tratamiento dependerá de la magnitud de infección y del antibiograma, basándose en una terapia antimicrobiana sensible y de amplio espectro, mientras que la profilaxis antibiótica dependerá del tipo de cirugía y sitio quirúrgico a ser intervenido, es por ello que la presente investigación tuvo como objetivo conocer el tratamiento y profilaxis de infección de herida quirúrgica, mediante una revisión bibliográfica de tipo no experimental descriptivo, comparando diferentes investigaciones científicas, en donde se concluyó que la infección de herida quirúrgica es una de las complicaciones que se presenta con mayor frecuencia en las unidades operativas, que dependen de factores endógenos y exógenos, por ende, es necesario utilizar profilaxis antibiótica, y en caso de existir infección usar el antibiótico adecuado según los signos clínicos que se identifique en el paciente.

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Section: Resultsunclassified

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

Chicaiza¹,

Guaita²,

Ocaña³

et al. 2023

LATAM

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Acute Cholecystitis in High-Risk Patients. Surgical, Radiological, or Endoscopic Treatment? Brazilian College of Digestive Surgery Position Paper

COELHO,

COSTA,

ENNE

et al. 2023

ABCD, arq. bras. cir. dig.

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Acute cholecystitis (AC) is an acute inflammatory process of the gallbladder that may be associated with potentially severe complications, such as empyema, gangrene, perforation of the gallbladder, and sepsis. The gold standard treatment for AC is laparoscopic cholecystectomy. However, for a small group of AC patients, the risk of laparoscopic cholecystectomy can be very high, mainly in the elderly with associated severe diseases. In these critically ill patients, percutaneous cholecystostomy or endoscopic ultrasound gallbladder drainage may be a temporary therapeutic option, a bridge to cholecystectomy. The objective of this Brazilian College of Digestive Surgery Position Paper is to present new advances in AC treatment in high-risk surgical patients to help surgeons, endoscopists, and physicians select the best treatment for their patients. The effectiveness, safety, advantages, disadvantages, and outcomes of each procedure are discussed. The main conclusions are: a) AC patients with elevated surgical risk must be preferably treated in tertiary hospitals where surgical, radiological, and endoscopic expertise and resources are available; b) The optimal treatment modality for high-surgical-risk patients should be individualized based on clinical conditions and available expertise; c) Laparoscopic cholecystectomy remains an excellent option of treatment, mainly in hospitals in which percutaneous or endoscopic gallbladder drainage is not available; d) Percutaneous cholecystostomy and endoscopic gallbladder drainage should be performed only in well-equipped hospitals with experienced interventional radiologist and/or endoscopist; e) Cholecystostomy catheter should be removed after resolution of AC. However, in patients who have no clinical condition to undergo cholecystectomy, the catheter may be maintained for a prolonged period or even definitively; f) If the cholecystostomy catheter is maintained for a long period of time several complications may occur, such as bleeding, bile leakage, obstruction, pain at the insertion site, accidental removal of the catheter, and recurrent AC; g) The ideal waiting time between cholecystostomy and cholecystectomy has not yet been established and ranges from immediately after clinical improvement to months. h) Long waiting periods between cholecystostomy and cholecystectomy may be associated with new episodes of acute cholecystitis, multiple hospital readmissions, and increased costs. Finally, when selecting the best treatment option other aspects should also be considered, such as costs, procedures available at the medical center, and the patient’s desire. The patient and his family should be fully informed about all treatment options, so they can help making the final decision.

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Antibiotic Prophylaxis for Abdominal Surgery: When to Recommend? Brazilian College of Digestive Surgery Position Paper

Freitas

Ferraz

Barchi

et al. 2023

ABCD, arq. bras. cir. dig.

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Background: Surgical antibiotic prophylaxis is an essential component of perioperative care. The use of prophylactic regimens of antibiotics is a well-established practice that is encouraged to be implemented in preoperative/perioperative protocols in order to prevent surgical site infections. Aims: To emphasize the crucial aspects of antibiotic prophylaxis in abdominal surgery. Results: Antibiotic prophylaxis is defined as the administration of antibiotics before contamination occurs, given with the intention of preventing infection by achieving tissue levels of antibiotics above the minimum inhibitory concentration at the time of surgical incision. It is indicated for clean operations with prosthetic materials or in cases where severe consequences may arise in the event of an infection. It is also suitable for all clean-contaminated and contaminated operations. The spectrum of action is determined by the pathogens present at the surgical site. Ideally, a single intravenous bolus dose should be administered within 60 minutes before the surgical incision. An additional dose should be given in case of hemorrhage or prolonged surgery, according to the half-life of the drug. Factors such as the patient's weight, history of allergies, and the likelihood of colonization by resistant bacteria should be taken into account. Compliance with institutional protocols enhances the effectiveness of antibiotic use. Conclusions: Surgical antibiotic prophylaxis is associated with reduced rates of surgical site infection, hospital stay, and morbimortality.

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Risk Factors for Surgical Wound Infection After Elective Laparoscopic Cholecystectomy

Cited by 3 publications

References 31 publications

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

Revisión bibliográfica: Infección de herida quirúrgica: profilaxis y tratamiento

Acute Cholecystitis in High-Risk Patients. Surgical, Radiological, or Endoscopic Treatment? Brazilian College of Digestive Surgery Position Paper

Antibiotic Prophylaxis for Abdominal Surgery: When to Recommend? Brazilian College of Digestive Surgery Position Paper

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