Velázquez MJD, García CSH, Velázquez MCA, Vázquez GMÁ, Vega MAJ

Language: Español
References: 20
Page: 32-37
PDF size: 276.87 Kb.

ABSTRACT

Objective: To know the prevalence of surgical site infections in patients subjected to either elective or emergence abdominal surgery at a General Surgery service in a second level health care center.
Setting: PEMEX Regional Hospital at Salamanca . Second level health care center.
Design: Prospective, transversal, descriptive and observational study.
Statistical analysis: Central tendency measures.
Patients and methods: We included those patients subjected to abdominal surgery at the General Surgery service, between the month of July and December 2007. We analyzed those that presented infection of the surgical site. We excluded those patients that were not operated in this hospital. Analyzed variables were age, gender, type of surgery, associated pathologies, and surgical complications.
Results: In the study period, we analyzed a total of 105 surgical procedures. There were 55 women (52.4%) and 50 men (47.61%), average age of 43 ± 26.5 years with a range of 3 to 83 years. Elective surgery was done in 75 patients, and 30 patients corresponded to emergency surgery. Performed surgeries were, in order of frequency, cholecystectomy, appendicectomy, inguinal plasties with mesh placement, placement of Tenckhoff catheter, exploratory laparotomies, umbilical plasties, and fundoplications. Of the total of procedures performed, six patients (5.7%) coursed with infection of the surgical site.
Conclusion: Prevalence of surgical wound infection in this study is similar to that reported by other authors. It is important to count upon prevention and treatment protocols for infections of surgical wounds. Besides, the characteristic microbiology of the institution and of each service has to be known for an adequate and optimal management of antibiotics.

References

1. Horan T, Gaynes R, Culver D. National Nosocomial Infections Surveillance (NNIS) System, CDC. Development of predictive risk factors for nosocomial surgical site infections (SSI). Infect Control Hosp Epidemiol 1994;15: P46 (M72).

2. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1999; 20: 250-278.

3. Horan T, Gaynes R, Martone WJ, Jarvis WE, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992; 13: 606-608.

4. National Nosocomial Infections Surveillance (NNIS) System. Report, data summary from January 1992 through June 2003, issued August 2003. Am J Infect Control 2003; 31: 481-498.

5. Fajardo-Rodríguez HA, Quemba-Gordillo, J, Eslava-Schmalbach J. Escalas de predicción e infección de sitio quirúrgico en 15625 cirugías 2001-2003. Rev Salud Pública (Bogota) 2005; 7: 89-98.

6. Norma Oficial Mexicana de Emergencia NOM-EM-002-SSA2-2003, para la vigilancia epidemiológica, prevención y control de las infecciones nosocomiales.

7. Bratzler DW, Houck PM, Richards C, Steele L, Dellinger EP, Fry DE, et al. Use of antimicrobial prophylaxis for major surgery: baseline results from the National Surgical Infection Prevention Project. Arch Surg 2005; 140: 174-182.

8. Kaye K, Anderson D, Sloane R, Chen L, Choi Y, Link K, et al. The effect of surgical site infection on older operative patients. J Am Geriatr Soc 2009; 57: 46-54.

9. Haridas M, Malangoni MA. Predictive factors for surgical site infection in general surgery. Surgery 2008; 144: 496-503.

10. Pessaux P, Msika S, Atalla D, Hay JM, Flamant Y. French Association for Surgical Research. Risk factors for postoperative infectious complications in noncolorectal abdominal surgery: a multivariate analysis based on a prospective multicenter study of 4718 patients. Arch Surg 2003; 138: 314-324.

11. Imai E, Ueda M, Kanao K, Kubota T, Hasegawa H, Omae K, et al. Surgical site infection risk factors identified by multivariate analysis for patient undergoing laparoscopic, open colon, and gastric surgery. Am J Infect Control 2008; 36: 727-731.

12. Poon JT, Law WL, Wong IW, Ching PT, Wong LM, Fan JK, et al. Impact of laparoscopic colorectal resection on surgical site infection. Ann Surg 2009; 249: 77-81.

13. Manniën J, Wille JC, Snoeren RL, Van den Hof S. Impact of postdischarge surveillance on surgical site infection rates for several surgical procedures: results from the nosocomial surveillance network in The Netherlands. Infect Control Hosp Epidemiol 2006; 27: 809-816.

14. Rocha Almazán M, Sánchez Aguilar M, Belmares Taboada J, Esmer Sánchez D, Tapia Pérez JH, Gordillo Moscoso A. Infección del sitio operatorio en cirugía abdominal no traumática. Cir Ciruj 2008; 76: 127-131.

15. Vargas-Domínguez A, Ortega-León LH, Rodríguez-Báez A, López-López JM, Zaldívar-Ramírez FR, Montalvo-Javé E. Vigilancia epidemiológica de infección del sitio operatorio superficial. Estudio comparativo de tres años. Cir Ciruj 2001; 69: 177-180.

16. Walz JM, Paterson CA, Seligowski JM, Heard SO. Surgical site infection following bowel surgery: a retrospective analysis of 1,446 patients. Arch Surg 2006; 141: 1014-1018.

17. Pessaux P, Atallah D, Lermite E, Msika S, Hay JM, Flamant Y, et al. Risk factors for prediction of surgical site infections in ‘‘clean surgery’’. Am J Infect Control 2005; 33: 292-298.

18. Pryor KO, Fahey TJ 3rd, Lien CA, Goldstein PA. Surgical site infection and the routine use of perioperative hyperoxia in a general surgical population: a randomized controlled trial. JAMA 2004; 291: 79-87.

19. The Joanna Briggs Institute. The impact of preoperative hair removal on surgical site infection. Best Practice 2003 Vol 7 Iss 2, Blackwell Publishing Asia, Australia.

20. Manniën J, Van den Hof S, Muilwijk J, Van den Broek PJ, Van Benthem B, Wille JC. Trends in the incidence of surgical site infection in the Netherlands. Infect Control Hosp Epidemiol 2008; 29: 1132-1138.