Prevalencia de las infecciones del sitio operatorio en una Institución Hospitalaria de alta complejidad, Barranquilla 2016
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Fecha
2018
Autores
Ortega Crespo, Gisella
Peña Andrade, Silvana
Diaz Tracevedo, Miryam
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Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
INTRODUCCIÓN: Las infecciones del sitio operatorio(ISO) son consideradas la segunda causa de infección asociada a la atención en salud IASS , los pacientes con herida quirúrgica limpia tiene un porcentaje bajo de desarrollar una infección del sitio operatorio (ISO) mientras que a los pacientes que se le realizaron cirugía abdominal tiene un porcentaje elevado de presentar una ISO, está por lo general tiende a desarrollarse dentro de los primeros 30 días seguidos a la intervención y en muchos casos se da antes que el paciente sea dado de alta. En la actualidad las ISO son una de las causas más frecuentes de eventos adversos de los servicio de cirugía ocasionando trastornos al paciente e institución hospitalaria, ya que se prolonga la estancia , aumento de costos, daños a la integridad emocional, física del paciente involucrando también su entorno familiar, retraso con su tratamiento médico y muchas veces desencadenando incluso la muerte Objetivo Determinar los factores de riesgo en las infecciones del sitio operatorio en una institución hospitalaria de alta complejidad en el año 2016. Material y método Es un estudio retrospectivo de corte transversal la muestra estuvo conformada por 259 historias tomada de la base de dato de Excel de pacientes con un diagnostico que posible mente pudieran presentar infecciones del sitio operatorio, posteriormente se revisó la base de dato en la cual se encontró que había paciente que tenían reingreso y reintervención y en algunos solo había reintervención mas no reingreso mientras otros habían reingresado y se manejó con tratamiento terapéutico. Resultados De 259 pacientes con diagnóstico de herida limpia- contaminada, contaminada, sucia e infectada se observó que estos pacientes en su mayoría fueron de sexo masculino, con edad promedio entre los 20-29 años pertenecientes al grupo etario de adulto jóvenes el servicio de cirugía que más presento ISO fue cirugía general, seguido de cirugía plástica y ortopedia, en cuanto al tiempo quirúrgico no se encontró como factor predisponente al desarrollo de ISO; lo mismo que la previa programación quirúrgica con respecto a las cirugías realizadas de urgencia no fueron relevantes en el desarrollo de la ISO Conclusión las causas de estas
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infecciones ISO muchas veces van atribuidas a los estados nutricionales de los pacientes, técnica que implemente el cirujano al momento de la cirugía, técnicas asépticas, dehiscencia de sutura, entre otras este estudio deja ver la necesidad de implementar protocolos basándose en las guías y recomendaciones de organización mundial de la salud (OMS) basándose en las necesidades básicas de cada institución y teniendo en cuenta la población que esta maneje; se notó que el uso de antibióticos no se ciñe a una guía de manejo sino a los gustos del especialista en turno, también es importante hacer una revisión de los sistemas de información que maneja la institución ya que son de vital importancia para el buen seguimiento de los pacientes así como la reestructuración del comité de vigilancia epidemiológica ya que no se encontraron indicadores de calidad y medición con reportes de las ISO en la institución.
INTRODUCTION: The infections of the operative site (ISO) are considered the second cause of infection associated with health care IASS, patients with clean surgical wound have a low percentage of developing an infection of the operative site (ISO) while patients who underwent abdominal surgery has a high percentage of presenting an ISO, this usually tends to develop within the first 30 days following the intervention and in many cases occurs before the patient is discharged. Nowadays, ISO is one of the most frequent causes of adverse events in the surgery service causing disorders to the patient and hospital institution, since the stay is prolonged, costs increase, damage to the emotional integrity, physical of the patient also involved their family environment, delay with medical treatment and often triggering even death Objective To determine the risk factors for surgical site infections in a high complexity hospital institution in 2016. Material and method This is a cross-sectional, retrospective study the sample consisted of 259 stories taken from the Excel data base of patients with a diagnosis that could possibly have infections of the operative site, later the database was revised in which it was found that there were patients who had readmission and reoperation and in some there was only reintervention but not re-enter So while others had re-entered and managed with therapeutic treatment. Results Of 259 patients diagnosed with a clean-contaminated wound, contaminated, dirty and infected it was observed that these patients were mostly male, with average age between 20-29 years belonging to the age group of young adults the surgery service that presented the most ISO was general surgery, followed by plastic surgery and orthopedics, in terms of surgical time, it was not found as a predisposing factor for the development of ISO; the same as the previous surgical programming with respect to the emergency surgeries were not relevant in the development of the ISO Conclusion the causes of these ISO infections are often attributed to the nutritional states of the patients, a technique that the surgeon implements at the moment of surgery, aseptic techniques, suture dehiscence, among others this study shows the need to implement protocols based 8 on the guidelines and recommendations of the World Health Organization (WHO) based on the basic needs of each institution and taking into account the population that is driving; it was noted that the use of antibiotics is not limited to a management guide but to the tastes of the specialist in turn, it is also important to review the information systems managed by the institution as they are of vital importance for the proper monitoring of the patients as well as the restructuring of the epidemiological surveillance committee since no quality and measurement indicators were found with ISO reports in the institution.
INTRODUCTION: The infections of the operative site (ISO) are considered the second cause of infection associated with health care IASS, patients with clean surgical wound have a low percentage of developing an infection of the operative site (ISO) while patients who underwent abdominal surgery has a high percentage of presenting an ISO, this usually tends to develop within the first 30 days following the intervention and in many cases occurs before the patient is discharged. Nowadays, ISO is one of the most frequent causes of adverse events in the surgery service causing disorders to the patient and hospital institution, since the stay is prolonged, costs increase, damage to the emotional integrity, physical of the patient also involved their family environment, delay with medical treatment and often triggering even death Objective To determine the risk factors for surgical site infections in a high complexity hospital institution in 2016. Material and method This is a cross-sectional, retrospective study the sample consisted of 259 stories taken from the Excel data base of patients with a diagnosis that could possibly have infections of the operative site, later the database was revised in which it was found that there were patients who had readmission and reoperation and in some there was only reintervention but not re-enter So while others had re-entered and managed with therapeutic treatment. Results Of 259 patients diagnosed with a clean-contaminated wound, contaminated, dirty and infected it was observed that these patients were mostly male, with average age between 20-29 years belonging to the age group of young adults the surgery service that presented the most ISO was general surgery, followed by plastic surgery and orthopedics, in terms of surgical time, it was not found as a predisposing factor for the development of ISO; the same as the previous surgical programming with respect to the emergency surgeries were not relevant in the development of the ISO Conclusion the causes of these ISO infections are often attributed to the nutritional states of the patients, a technique that the surgeon implements at the moment of surgery, aseptic techniques, suture dehiscence, among others this study shows the need to implement protocols based 8 on the guidelines and recommendations of the World Health Organization (WHO) based on the basic needs of each institution and taking into account the population that is driving; it was noted that the use of antibiotics is not limited to a management guide but to the tastes of the specialist in turn, it is also important to review the information systems managed by the institution as they are of vital importance for the proper monitoring of the patients as well as the restructuring of the epidemiological surveillance committee since no quality and measurement indicators were found with ISO reports in the institution.
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Palabras clave
Infecciones, Cirugía, Prevalencia, Heridas, Causas, Infections, Surgery, Prevalence, Injuries, Causes