Revisión sistemática de las infecciones asociadas a la atención en salud en instituciones hospitalaria con servicios de cirugías en Barranquilla
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Fecha
2020
Autores
Acuña Estrada, Javier
De La Peña, Emilia Elitin
Hurtado Mercado, Fidelina
Villanueva Orozco, Margarita
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Ediciones Universidad Simón Bolívar
Facultad de Administración y Negocios
Facultad de Administración y Negocios
Resumen
Determinar la incidencia en la infección del sitio quirúrgico (ISQ) por
especialidad médica quirúrgica, es relevante para el abordaje holístico de los
pacientes, y de esta manera tratarlos anticipadamente, para disminuir
significativamente el riesgo. la ISQ es catalogada como: “una infección que ocurre
dentro de los 30 a 90 días posteriores a un procedimiento quirúrgico y a menudo se
localizan en el sitio de la incisión, pero también pueden extenderse a los tejidos
profundos”; las ISQ forman parte de la segunda causa por Infecciones Asociadas a
la Atención en Salud (IAAS), también denominadas infecciones nosocomiales u
hospitalarias. Según las Organización Mundial de la Salud (OMS), las IAAS son
infecciones que sufre un paciente durante su estancia hospitalaria y que, a su vez,
este paciente no sostenía dicha infección, así como tampoco, existiese incubación
en el momento del ingreso. Actualmente, las IAAS por ISQ son causa de reingreso
del paciente al servicio hospitalario, aumentando el tiempo de incapacidad,
exposición ha antimicrobianos, secuelas físicas, discapacidades, aumento del
presupuesto sanitario para la atención e incluso desenlaces fatales como la muerte
Objetivos: determinar la incidencia de las infecciones del sitio quirúrgico por
especialidad médico quirúrgica en una Institución de salud de alta complejidad en
la ciudad de Barranquilla durante el año 2016.
Materiales y Métodos: estudio descriptivo, retrospectivo de corte transversal, se
realizó búsqueda en base de datos institucional en Excel y se analizó la información
con el programa estadístico SPSS versión 22. La muestra estuvo conformada por
259 historia clínicas de pacientes con ISQ. Se tuvo en cuenta como criterios De
Inclusión: los registros de historia clínica consignados en la base de datos
institucional con información completa, intervenidos quirúrgicamente en el periodo
de enero a diciembre del año 2016. Los registros de historia clínica de paciente cuya
herida quirúrgica esté clasificada como: limpias-contaminas, contaminadas, sucias
y/o sucias e infectadas y los reportes de Pacientes con ISQ por la institución
hospitalaria. Además, se excluyeron los registros de la historia clínica incompletos
en la base de datos.
Resultados: el 40% eran mujeres y el 60% hombres, el 24.71% tenían una edad
comprendida entre 24-29 años, seguido del 15.83% entre 40-49 años, 7.4%, entre
60-69 años; de acuerdo a la especialidad, cirugía general 36, cirugía plástica 22%,
ortopedia 22%; en cuanto a la programación, cirugías programadas se presentó el
50.2%, cirugías no programadas 1.5% y cirugías de urgencias 48.3%.
Conclusiones: Las infecciones del sitio operatorio es una de las infecciones
asociadas a la atención en salud más común, siendo los procedimientos practicados
por cirugía general los más frecuentes; por tanto, es de imperiosa necesidad
actualizar los lineamientos en los servicios de cirugía y evaluar la adherencia a los
mismo, debido a que las repercusiones de las ISQ conllevan a un mayor gasto
sanitario e incomodidad físicas, psicológicas y económicas al paciente y a la familia
que las sufre, también, censura la participación de los actores en salud de la
institución donde se reporta, por tal razón, se recomienda el fortalecimiento de los
comités de infecciones o vigilancia epidemiológica de las instituciones, que permita
analizar desde la evidencia científica sus actuaciones y tomar decisiones precisas,
teniendo en cuenta que los cuidados y diagnósticos son individualizados, partiendo
de la identificación del grupo de edad más susceptible a presentar ISQ, y el nivel de
compromiso del paciente en cuanto comorbilidades se refiere, dado que, en efecto,
los antecedentes personales son un elemento importante a tener presente para la
prevención de infección del sitio quirúrgico
Determining the incidence of surgical site infection (SSI) by surgical medical specialty is relevant for the holistic approach to patients, and thus treating them early, to significantly reduce the risk. SSI is categorized as: "an infection that occurs within 30 to 90 days after a surgical procedure and is often localized at the incision site, but can also spread to deep tissues"; SSIs are part of the second cause of Infections Associated with Health Care (HAI), also called nosocomial or hospital infections. According to the World Health Organization (WHO), HAIs are infections that a patient suffers during their hospital stay and that, in turn, this patient did not sustain said infection, as well as there was no incubation at the time of admission. Currently, HAIs due to SSIs are the cause of re-admission of the patient to the hospital service, increasing the time of disability, exposure to antimicrobials, physical sequelae, disabilities, increased health care budget and even fatal outcomes such as death Objectives: to determine the incidence of surgical site infections by surgical medical specialty in a highly complex health institution in the city of Barranquilla during 2016. Materials and Methods: a descriptive, retrospective cross-sectional study, an institutional database in Excel was searched and the information was analyzed with the statistical program SPSS version 22. The sample consisted of 259 medical records of patients with SSI. Inclusion criteria were taken into account: the clinical history records consigned in the institutional database with complete information, surgically intervened in the period from January to December 2016. The clinical history records of patients whose surgical wound is classified such as: cleancontaminated, contaminated, dirty and / or dirty and infected and the reports of Patients with SSI by the hospital institution. Additionally, incomplete medical history records in the database were excluded. Results: 40% were women and 60% men, 24.71% had an age between 24-29 years, followed by 15.83% between 40-49 years, 7.4%, between 60-69 years; according to specialty, general surgery 36, plastic surgery 22%, orthopedics 22%; Regarding the programming, 50.2% presented scheduled surgeries, 1.5% unscheduled surgeries and 48.3% emergency surgeries. Conclusions: Surgical site infections are one of the most common health careassociated infections, with general surgery procedures being the most frequent; Therefore, it is imperative to update the guidelines in surgery services and evaluate adherence to them, because the repercussions of SSIs lead to higher health costs and physical, psychological and financial discomfort to the patient and family who The participation of the health actors of the institution where it is reported also suffers from censorship, for this reason, it is recommended to strengthen the infection committees or epidemiological surveillance of the institutions, which allows analyzing their actions and actions from the scientific evidence make precise decisions, taking into account that the care and diagnoses are individualized, starting from the identification of the age group most susceptible to presenting SSI, and the level of commitment of the patient regarding comorbidities, since, in effect, the antecedents Personnel are an important element to keep in mind for the prevention of surgical site infection.
Determining the incidence of surgical site infection (SSI) by surgical medical specialty is relevant for the holistic approach to patients, and thus treating them early, to significantly reduce the risk. SSI is categorized as: "an infection that occurs within 30 to 90 days after a surgical procedure and is often localized at the incision site, but can also spread to deep tissues"; SSIs are part of the second cause of Infections Associated with Health Care (HAI), also called nosocomial or hospital infections. According to the World Health Organization (WHO), HAIs are infections that a patient suffers during their hospital stay and that, in turn, this patient did not sustain said infection, as well as there was no incubation at the time of admission. Currently, HAIs due to SSIs are the cause of re-admission of the patient to the hospital service, increasing the time of disability, exposure to antimicrobials, physical sequelae, disabilities, increased health care budget and even fatal outcomes such as death Objectives: to determine the incidence of surgical site infections by surgical medical specialty in a highly complex health institution in the city of Barranquilla during 2016. Materials and Methods: a descriptive, retrospective cross-sectional study, an institutional database in Excel was searched and the information was analyzed with the statistical program SPSS version 22. The sample consisted of 259 medical records of patients with SSI. Inclusion criteria were taken into account: the clinical history records consigned in the institutional database with complete information, surgically intervened in the period from January to December 2016. The clinical history records of patients whose surgical wound is classified such as: cleancontaminated, contaminated, dirty and / or dirty and infected and the reports of Patients with SSI by the hospital institution. Additionally, incomplete medical history records in the database were excluded. Results: 40% were women and 60% men, 24.71% had an age between 24-29 years, followed by 15.83% between 40-49 years, 7.4%, between 60-69 years; according to specialty, general surgery 36, plastic surgery 22%, orthopedics 22%; Regarding the programming, 50.2% presented scheduled surgeries, 1.5% unscheduled surgeries and 48.3% emergency surgeries. Conclusions: Surgical site infections are one of the most common health careassociated infections, with general surgery procedures being the most frequent; Therefore, it is imperative to update the guidelines in surgery services and evaluate adherence to them, because the repercussions of SSIs lead to higher health costs and physical, psychological and financial discomfort to the patient and family who The participation of the health actors of the institution where it is reported also suffers from censorship, for this reason, it is recommended to strengthen the infection committees or epidemiological surveillance of the institutions, which allows analyzing their actions and actions from the scientific evidence make precise decisions, taking into account that the care and diagnoses are individualized, starting from the identification of the age group most susceptible to presenting SSI, and the level of commitment of the patient regarding comorbidities, since, in effect, the antecedents Personnel are an important element to keep in mind for the prevention of surgical site infection.
Descripción
Palabras clave
Infección de la herida quirúrgica, Cirugía, Factores de riesgo, Medicina perioperatoria, Surgical wound infection, Surgery, Risk factors, Perioperative medicine