Navegando por Assunto "cirurgia"

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    Indicadores de processo para a prevenção da infecção do sítio cirúrgico em um hospital universitário do centro-oeste brasileiro
    (Universidade Federal de Goiás, 2013-03-26) Gebrim, Cyanéa Ferreira Lima; Barreto, Regiane Aparecida dos santos Soares; Palos, Marinésia Aparecida Prado; Palos, Marinésia Aparecida Prado; Mrué, Mrué; Bezerra, Ana Lúcia Queiroz Bezerra; Brandão, Marcelo Luiz; Sousa, Adenícia Custódia Silva e
    INTRODUCTION: Evidence shows that out of every ten people in the world, one has been the victim of medical errors or preventable adverse events. These statistics are further evidence that of the 234 million patients undergoing surgeries, seven million suffer postoperative complications, increasing mortality rates by around 0.4 to 10%. A surgical site infection is considered the second highest incidence of major impact to the morbidity and mortality of patients, and may cause irreparable physical and emotional harm, as well as increase the cost of therapy for institutions. This reality drove the Safe Surgery Saves Lives program, which is the second Global Challenge for the World Alliance for Patient Safety program, launched by the World Health Organization in 2004. Studies organized by the National Health Surveillance Agency of Brazil, derived from these campaigns, cataloged nine process indicators to prevent these infections, which were the subject of this investigation. OBJECTIVE: To examine the process indicators for the prevention of surgical site infection in the perioperative period in patients undergoing clean surgery in a teaching hospital in central-western Brazil. METHODS: Retrospective analytical cohort study, conducted in 700 records of patients aged 18 years or older undergoing clean surgical procedures from January 2008 to December 2010. We used a structured form, previously evaluated according to national guidelines. Data were entered into SPSS version 15 for Windows. The analysis was descriptive and multivariate, and used chi-square tests, Fisher, and odds ratio (OR) as measures of association for variables with p <0.10. Statistically significant associations with p <0.05 were considered. RESULTS: Regarding the socio-demographic profile of the patients, 57.1% were female, aged between 18 and 101 years, 39.3% had comorbidities, 74.5% with ASA ≤ II. Regarding surgical specialty, 29.9% were orthopedic and 19.9% were vascular. Nonconforming indicators were found in 64.6%. Aspects such as the time of preoperative hospitalization, the method used for hair removal, the duration of antimicrobial prophylaxis, glycemic control in diabetics, as well as the thermal controls and inspection records of the surgical cases were not considered appropriate. The predictors for surgical site infection in the univariate analysis were male gender, carriers of chronic disease, alcoholism and smoking, infections already present on admission, a length of preoperative hospital stay of greater than 5 days, ASA ≥ III, shaving and antimicrobial prophylaxis; the independent factors were: being a carrier of a chronic disease, infections already present on admission and shaving with a razor blade. The estimated rate of infection was 10%. The surgical specialty with the highest rate of infection was vascular, with 25.9%. The methicillin-resistant Staphylococcus aureus was the most evident causative agent. CONCLUSION: We conclude that the service partially meets the process indicators for the prevention of surgical site infection in the perioperative period of clean surgeries, incongruent with the principles of the Safe Surgery Saves Lives program.
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    Braçadeira de poliamida e fio de náilon na ovário-histerectomia em gatas
    (Universidade Federal de Goiás, 2012-02-24) PRADO, Tales Dias do; BORGES, Naída Cristina; http://lattes.cnpq.br/9181279951885005; ROZA, Marcello Rodrigues da; http://lattes.cnpq.br/6208651430407499; DAMASCENO, Adilson Donizeti; http://lattes.cnpq.br/3900110295277130
    Ovariohysterectomy is the most performed surgery in small animals, with the purpose of birth control, avoiding pseudocyesis as also treating female reproductive tract affections. Several surgery techniques have been described. Beyond the traditional midline approach to the abdomen, the flank many laparoscopic approaches may be performed. Twenty-four healthy, mongrel and adult cats took part of the study. They were randomly distributed in four groups of six animals, this way: GI midline approach and ligature with nylon thread; GII midline approach and ligature with nylon clamp; GIII flank approach and ligature with nylon thread and GIV flank approach and ligature with nylon clamp. The times of dieresis, ovariohysterectomy and closure were timed. Clinic evaluations were done at the day of the surgery and at 7 and 28 days after it. Ultrassonographic evaluations were performed at the day of the surgery, before and after it, and at 7 and 28 days after it, to verify possible alterations related to the material used. The results revealed that the midline approach was significantly faster than the flank approach. The ligature time of the pedicles and uterus body, as the total surgery time were statistically shorter for the groups that used the nylon clamp. We also observed a higher incidence of edema in the groups of midline approach at the seventh day after surgery, however at the twenty-eighth day after surgery, all the wounds healed equally. We concluded that the nylon clamps were secure to be use in cats ovariohysterectomies. Also, the flank approach takes more time to be performed than the midline one. The incidence of edema is considerable higher in the groups of midline access.