Incidencia de infección del sitio quirúrgico en cirugía laparoscópica de enero 2016 - diciembre 2016
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Medicina
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Objetivo: Determinar la prevalencia de infecciones del sitio quirúrgico en cirugías mínimamente invasivas en el servicio de cirugía general del hospital Teodoro Maldonado Carbo, durante Enero 2016 – Diciembre 2016. Metodología: El Universo serán los pacientes intervenidos por cirugía general por vía laparoscópica. Se trata de un estudio analítico, observacional de cohorte retrospectivo. Resultados: Se evaluaron un total de 1917 pacientes, de los cuales 1040 (54,25%) fueron cirugías programadas y el 877 restante, representando el 45,75% de las cirugías, fueron de urgencia. La cirugía realizada con más frecuencia fue la de Colecistectomía laparoscópica con un porcentaje del 90,30%, debiéndose a que son cirugías laparoscópicas generalmente programadas, al igual que las cirugías de manga gástrica con 7,72% que se realizan exclusivamente por vía laparoscópica. Las cirugías de apendicetomía y otros procedimientos quirúrgicos como las herniorrafias se realizan generalmente con la técnica abierta por lo que su frecuencia es considerablemente menor en comparación con las demás. Conclusión: Se observa una disminución mínima de la incidencia en comparación con la literatura descrita. Cabe la incógnita de si los factores resultantes de esta disminución corresponde a que el manejo quirúrgico y la aplicación de las tasas predictores y el uso de los factores de riego previo a las cirugías sirven de manera eficaz y los resultados son los esperados, o existe errores en el sistema de recolección de datos y códigos en los hospitales. Un tiempo de hospitalización prolongado, así como la cirugía de urgencia constituye un factor de riesgo frente a infección del sitio quirúrgico. Es probable que ello esté relacionado con el periodo de administración de antibiótico por vía endovenosa, y el abordaje laparoscópico exclusivo, respectivamente
Palabras claves: Infección postoperatoria, Infección sitio quirúrgico, Factores de riesgo, Índice NNIS
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Objective: To determine the prevalence of infections of the surgical site in minimally invasive surgeries in the general surgery service of Teodoro Maldonado Carbo Hospital, during January 2016 - December 2016. Methodology: The Universe will be the patients intervened by general laparoscopic surgery. It is an analytical, observational retrospective cohort study. Results: A total of 1917 patients were evaluated, of which 1040 (54.25%) were scheduled surgeries and the remaining 877, representing 45.75% of the surgeries, were emergency. The most frequently performed surgery was laparoscopic cholecystectomy with a percentage of 90.30%, due to the fact that they are generally scheduled laparoscopic surgeries, as well as gastric sleeve surgeries with 7.72% that are performed exclusively laparoscopically. Appendectomy surgeries and other surgical procedures such as herniorrhaphy are usually done with the open technique, so their frequency is considerably lower compared to the others. Conclusion: There is a minimal decrease in incidence compared to the literature described. The question is whether the factors resulting from this decrease correspond to the fact that surgical management and the application of predictive rates and the use of irrigation factors prior to surgeries are effective and the results are as expected, or there are errors in the system of data collection and codes in hospitals. A prolonged hospitalization time, as well as emergency surgery, is a risk factor for surgical site infection. It is likely that this is related to the period of administration of intravenous antibiotic, and the exclusive laparoscopic approach, respectively
Objective: To determine the prevalence of infections of the surgical site in minimally invasive surgeries in the general surgery service of Teodoro Maldonado Carbo Hospital, during January 2016 - December 2016. Methodology: The Universe will be the patients intervened by general laparoscopic surgery. It is an analytical, observational retrospective cohort study. Results: A total of 1917 patients were evaluated, of which 1040 (54.25%) were scheduled surgeries and the remaining 877, representing 45.75% of the surgeries, were emergency. The most frequently performed surgery was laparoscopic cholecystectomy with a percentage of 90.30%, due to the fact that they are generally scheduled laparoscopic surgeries, as well as gastric sleeve surgeries with 7.72% that are performed exclusively laparoscopically. Appendectomy surgeries and other surgical procedures such as herniorrhaphy are usually done with the open technique, so their frequency is considerably lower compared to the others. Conclusion: There is a minimal decrease in incidence compared to the literature described. The question is whether the factors resulting from this decrease correspond to the fact that surgical management and the application of predictive rates and the use of irrigation factors prior to surgeries are effective and the results are as expected, or there are errors in the system of data collection and codes in hospitals. A prolonged hospitalization time, as well as emergency surgery, is a risk factor for surgical site infection. It is likely that this is related to the period of administration of intravenous antibiotic, and the exclusive laparoscopic approach, respectively
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Cirugía laparoscópica, Infección de la herida quirúrgica, Factores de riesgo, Infección posoperatoria de la herida, Incidencia, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador