Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Postoperative care"

Navegando por Palavras-chave "Postoperative care"

Agora exibindo 1 - 15 de 15

Acesso aberto (Open Access)
Análise perioperatória de morbimortalidade em neurocirurgia pediátrica
(Universidade Federal de São Paulo (UNIFESP), 2011-03-30) Mekitarian Filho, Eduardo [UNIFESP]; Carvalho, Werther Brunow de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Introduction. The increasing complexity and improving care assistance and monitoring of children undergoing neurosurgical procedures has been remarkable in recent years. However, there are few publications about the main characteristics of perioperative morbidity and risk factors associated with worse outcomes from them. Objectives. To study, retrospectively, the main determinants of morbidity and mortality in children undergoing neurosurgical procedures hospitalized in the Hospital Santa Catarina’s Pediatric Intensive Care Unit and characterize them in to know the profile of the service studied. Methods. A retrospective cohort study was conducted using medical records review between 2005 to 2009 of all patients undergoing neurosurgical procedures, from 1 month to 16 years, and the main data regarding the diagnosis and surgical postoperative outcome and main complications and outcome of patients during hospitalization were reviewed. Results. We studied data from 198 patients during the study period. The most common diagnoses were craniosynostosis (31.3%), supratentorial tumors (19.7%), ventriculoperitoneal shunts (16.7%), spinal cord tumors (9.1%) and infratentorial tumors (8.6%) . Altogether, 57.6% of patients were male with a mean age of 50 months, mean ICU stay of 3.4 days and hospital stay of 7.2 days with an average time of mechanical ventilation of 6.6 hours. The most frequent complications were bleeding (48.5%), fever (30.3%), hypothermia (16.2%) and post-extubation laryngitis (15.2%). In the multivariate analysis, the risk factors associated with longer ICU lenght-of-stay were fever (p = 0.001), laryngitis (p = 0.001) and infection (p = 0.003); with greater hospital stay, fever (p = 0.001) and infection (p = 0.003) and with greater duration of mechanical ventilation, fever (p = 0.015), bleeding (p = 0.04), laryngitis (p = 0.007), coagulation disorders (p <0.001) and use of corticosteroids (p <0.001). There were two deaths in this population due to intracranial hypertension. Conclusions. It’s very important to study the major complications associated with poor prognosis in pediatric neurosurgery. Fever and bleeding were very frequent, impacting on almost all outcomes studied. Case series with the largest number of patients are needed to better establish the risk factors.
Acesso aberto (Open Access)
Application time for postoperative wound dressing following breast augmentation with implants: study protocol for a randomized controlled trial
(Biomed Central Ltd, 2015-01-27) Mendes, Denise de Almeida [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Veiga-Filho, Joel [UNIFESP]; Fonseca, Fernando Elias Martins; Paiva, Luiz Francisley de; Novo, Neil Ferreira; Loyola, Ana Beatriz Alkmin Teixeira; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Vale Sapucai
Background: Breast augmentation with silicone implants is one of the most frequently performed cosmetic surgeries worldwide. Surgical site infection (SSI) remains an important complication of this procedure. One of the most important risk factors for SSI is the presence of microorganisms on the skin surrounding the wound. Guidelines by the Centers for Disease Control (CDC) recommend that surgical wounds be covered with a sterile dressing for 24 to 48 hours. However, a recent study showed that the application of a dressing for six days after breast reduction reduced wound colonization by coagulase-negative staphylococci.Methods/Design: A randomized clinical trial was designed to assess two protocols of postoperative wound care to determine how the application duration of the postoperative dressing influences wound colonization in patients undergoing breast augmentation with silicone implants. Women aged between 18 and 60 years who are candidates for breast augmentation with silicone implants will be randomly allocated to group I (n = 48), in which the dressing will be removed on the first postoperative day, or group II (n = 48), in which the dressing will be removed on the sixth postoperative day. Cutaneous colonization will be assessed by cultures of samples of skin flora taken from the wound region. the incidence of SSI, using standardized CDC criteria, and the perceptions of patients towards the dressing will be secondary outcomes.Discussion: An important component of SSI prevention is to minimize all possible risk factors, and the application of postoperative dressing plays a key role in this endeavor. the results of this clinical trial may help to standardize postoperative wound care after breast augmentation with silicone implants.
Somente Metadadados
Comparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients
(W B Saunders Co-Elsevier Inc, 2016) de Oliveira, Olivia Haun [UNIFESP]; Rezende de Freitas, Flavio Geraldo [UNIFESP]; Ladeira, Renata Teixeira [UNIFESP]; Fischer, Claudio Henrique [UNIFESP]; Bafi, Antonio Tonete [UNIFESP]; Pontes Azevedo, Luciano Cesar [UNIFESP]; Machado, Flavia Ribeiro [UNIFESP]
Purpose: The objective of our study was to assess the reliability of the distensibility index of the inferior vena cava (dIVC) as a predictor of fluid responsiveness in postoperative, mechanically ventilated patients and compare its accuracy with that of the pulse pressure variation (PPV) measurement. Materials and methods: We included postoperative mechanically ventilated and sedated patients who underwent volume expansion with 500 mL of crystalloids over 15 minutes. A response to fluid infusion was defined as a 15% increase in the left ventricular outflow tract velocity time integral according to transthoracic echocardiography. The inferior vena cava diameters were recorded by a subcostal view using the M-mode and the PPV by automatic calculation. The receiver operating characteristic (ROC) curves were generated for the baseline dIVC and PPV. Results: Twenty patients were included. The area under the ROC curve for dIVC was 0.84 (95% confidence interval, 0.63-1.0), and the best cutoff value was 16% (sensitivity, 67%
Acesso aberto (Open Access)
Comparison study of two different patient-controlled anesthesia regiments after cardiac surgery
(Sociedade Brasileira de Cirurgia Cardiovascular, 2010-03-01) Mota, Fabiane de Almeida [UNIFESP]; Marcolan, Joao Fernando [UNIFESP]; Pereira, Mara Helena Corso; Milanez, Adriano Márcio de Melo; Dallan, Luis Alberto Oliveira; Diccini, Solange [UNIFESP]; Clinics Hospital; Universidade Federal de São Paulo (UNIFESP); Heart Institute; Heart Institute Heart Surgical Diseases Group
INTRODUCTION: Acute and severe pain is frequent in patients who undergo cardiothoracic surgery. Patient controlled analgesia (PCA) can be used to manage postoperative pain. OBJECTIVE: To compare analgesia of morphine PCA alone (without continous infusion) with morphine PCA plus a continuous infusion on postoperative period after cardiac surgery and to evaluate pain scores, morphine consumption, number of demand, patient satisfaction and side effects. METHODS: Randomized trial was conducted to assess patients who underwent cardiac surgery receiving either morphine PCA alone or morphine PCA plus continous infusion. In the post operative period, PCA was started at extubation in both regiments according to randomization. Pain intensity, morphine consumption, number of demand, satisfaction and side effects were assessed at zero, six, twelve, eighteen, twenty four and thirty hours after patients' extubation. RESULTS: The study enrolled 100 patients. 50 patients received morphine PCA alone, (Group A) and 50 patients received morphine PCA plus a background infusion, (Group B). Group B patients had less demand, consumed more morphine and were more satisfied regarding analgesia. No statistical differences were shown between groups related to pain intensity, and side effects. CONCLUSIONS: Pain control was effective and similar in both groups. Morphine PCA alone seems to be better for postoperative pain manage in cardiac surgery, due to its less morphine expense with the same effectiveness.
Acesso aberto (Open Access)
Construção e validação de protocolo clínico para assistência ao paciente no pós-operatório de transplante cardíaco em unidade de terapia intensiva
(Universidade Federal de São Paulo, 2022-01-28) Sant’Anna, Ana Lúcia Gargione Galvão de [UNIFESP]; Machado, Regimar Carla [UNIFESP]; http://lattes.cnpq.br/1310723429860987; http://lattes.cnpq.br/8430563252181123
Objetivos: Construir e validar um protocolo para assistência ao paciente no pós-operatório de transplante cardíaco na unidade de terapia intensiva. Métodos: Estudo metodológico baseado no referencial de Spínola, referente à validação de conteúdo de um protocolo clínico que seguiu três etapas. Na etapa 1 (proposta do protocolo) construiu-se o instrumento de coleta de dados delineado em evidências da literatura científica e na experiência profissional dos pesquisadores, contendo 03 categorias, 09 tópicos, 31 itens e 106 subitens assistenciais. Na etapa 2 (validação de conteúdo) realizou-se a apreciação das variáveis da proposta do protocolo (primeira rodada de Delphi) por meio de ajuizamento com comitê de especialistas na temática. Posteriormente, realizou-se uma revisão integrativa da literatura referente as complicações no pós-operatório de transplante cardíaco composta por seis etapas e estratégia PICOT. A busca foi realizada em oito bases de dados (LILACS, MEDLINE®/PubMed®, Embase®, CINAHL, Cochrane Library®, Scopus®, Web of Science e Ovid) e para seleção dos artigos utilizou-se o programa Rayyan QCRI. Em seguida procedeu-se ao ajuizamento das variáveis do protocolo (segunda rodada de Delphi) com a avaliação por experts brasileiros e estrangeiros. Na etapa 3 realizou-se a construção das variáveis do protocolo clínico (constructo final). Este estudo foi aprovado pelo CEP UNIFESP CAAE: 18298919.6.0000.5505. Resultados: Na primeira rodada de Delphi realizou-se, por videoconferência, a análise das variáveis propostas no instrumento de coleta de dados pelo comitê de especialistas na temática, composto por 02 médicos e 02 enfermeiras, assim compôs-se de 03 categorias, 09 tópicos, 31 itens e 119 subitens. Na revisão integrativa da literatura foram incluídos 05 artigos referentes ao período pós-operatório imediato. Na segunda rodada de Delphi participaram 04 (44,4%) experts do Brasil, 04 (44,4%) da Espanha e 01 (11,1%) do Equador com prática clínica em pós-operatório de transplante cardíaco entre 2 e 30 anos. Os resultados computaram 105 (88,2%) subitens com índice de validade de conteúdo total (IVC-T) de 01 (100,0%) e demostrou que a maioria obteve o IVC > 0,80 (80,0%) estipulado para este estudo. Conclusão: O protocolo (constructo final) foi estruturado com 03 categorias, 09 tópicos, 31 itens e 119 subitens, visando ser um instrumento para garantir a segurança do paciente e a qualidade da assistência prestada articulada aos avanços tecnológicos.
Acesso aberto (Open Access)
Drenagem torácica pós-pneumonectomia: sim ou não? Estudo retrospectivo
(Sociedade Brasileira de Pneumologia e Tisiologia, 2006-08-01) Thomson, João Carlos; Ferreira Filho, Olavo Franco [UNIFESP]; Universidade Estadual de Londrina Programa de Mestrado e Doutorado em Medicina e Ciências da Saúde; Universidade Federal de São Paulo (UNIFESP); Universidade Estadual de Londrina Centro de Ciências da Saúde Departamento de Clínica Médica
OBJECTIVE: To evaluate the need for post-pneumonectomy thoracic drainage. METHODS: This was a retrospective study of 46 patients having undergone pneumonectomy in the Thoracic Surgery Department of the Londrina University Hospital between January of 1998 and December of 2004. Patients were divided into two groups: those having been submitted to drainage and those not having been. The diseases involved were lung cancer, bronchiectasis and tuberculosis. RESULTS: Drainage was used in 21 patients, whereas no drainage was used in 25. The most common postoperative complication was subcutaneous emphysema (12 cases). Hospital stays were of shorter duration among patients who were not submitted to drainage than among those who were (mean, 6.5 days vs. 10.2 days). No serious postoperative complications were observed in the group of patients not submitted to drainage. CONCLUSION: The findings that evolutions were more favorable and hospital stays were shorter for the patients not submitted to drainage call into question the need for routine post-pneumonectomy drainage.
Acesso aberto (Open Access)
Dressing wear time after breast reconstruction: study protocol for a randomized controlled trial
(Biomed Central Ltd, 2013-02-22) Veiga, Daniela Francescato [UNIFESP]; Veiga-Filho, Joel; Damasceno, Carlos Americo Veiga; Sales, Edilaine Maria Leci; Morais, Thiago Bezerra; Almeida, Wania Eliza; Novo, Neil Ferreira; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Vale do Sapucai
Background: One of the major risk variables for surgical site infection is wound management. Understanding infection risk factors for breast operations is essential in order to develop infection-prevention strategies and improve surgical outcomes. the aim of this trial is to assess the influence of dressing wear time on surgical site infection rates and skin colonization. Patients' perception at self-assessment will also be analyzed.Methods/Design: This is a two-arm randomized controlled trial. Two hundred breast cancer patients undergoing immediate or delayed breast reconstruction will be prospectively enrolled. Patients will be randomly allocated to group I (dressing removed on postoperative day one) or group II (dressing removed on postoperative day six). Surgical site infections will be defined by standard criteria from the Centers for Disease Control and Prevention (CDC). Skin colonization will be assessed by culture of samples collected at predefined time points. Patients will score dressing wear time with regard to safety, comfort and convenience.Discussion: the evidence to support dressing standards for breast surgery wounds is empiric and scarce. CDC recommends protecting, with a sterile dressing for 24 to 48 hours postoperatively, a primarily closed incision, but there is no recommendation to cover this kind of incision beyond 48 hours, or on the appropriate time to shower or bathe with an uncovered incision. the results of the ongoing trial may support standard recommendations regarding dressing wear time after breast reconstruction.
Acesso aberto (Open Access)
Estudo randomizado do tratamento cirúrgico da síndrome do túnel do carpo
(Sociedade Brasileira de Ortopedia e Traumatologia, 2007-01-01) Nascimento, Thiago Francisco Do; D'elia, Luiz Fernando Barbiere; Gonçalves, Lucas Oliveira; Dobashi, Eiffel Tsuyoshi [UNIFESP]; Instituto de Fratura, Ortopedia e Reabilitação; Universidade Federal de São Paulo (UNIFESP)
This paper aims to evaluate, by means of a randomized prospective clinical study, two distinct groups divided according to the surgical methodology applied. The first group (group A) was treated by endoscopic operation and the second (group B) one by open access. We evaluated 55 patients (57 wrists), 32 (56.0%) females and 25 (44,0%) males. The sample was composed by 36 (65.5%) Caucasian, 17 (30.9%) black and 2 (3.63%) Asian patients. The mean age was 34.75 years (minimum of 24 y.o. and maximum of 76 y.o.). Group A was composed by 30 (52.63%) wrists and group B by 27 (47.36%). All the patients were pre- and postoperatively evaluated at 1, 2, 4, 6 and 12 weeks after surgery and the following parameters were considered: thenar muscle trophism, pain (analogical scale), sensibility with Semmes-Weinstein monofilament, grip strength and finger pinch (with Jamar dynamometer). We did not find significant statistical differences regarding side, dominancy, hypotrophy, pain and strength. The non-parametric Mann-Whitney's test (p = 0.0178) showed that the group of patients submitted to endoscopic operation were able to resume professional the activities. Our study did not evidence, at the end of statistical analysis, statistically significant differences comparing the both methods of surgical treatment.
Acesso aberto (Open Access)
Implementation of a guideline for physical therapy in the postoperative period of upper abdominal surgery reduces the incidence of atelectasis and length of hospital stay
(Elsevier B.V., 2014-03-01) Possa, Samantha Souza; Amador, Claudemir Braga; Costa, Alberto Meira; Sakamoto, Eliana Takahama; Kondo, Cláudia Seiko [UNIFESP]; Maida, Ana Lígia Vasconcellos; Brito, Christina May Moran de; Yamaguti, Wellington Pereira dos Santos; Hosp Sirio Libanes; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)
Objective: the aim of this study was to evaluate the effectiveness of implementing a physical therapy guideline for patients undergoing upper abdominal surgery (UAS) in reducing the incidence of atelectasis and length of hospital stay in the postoperative period.Materials and methods: A before and after study design with historical control was used. the before period included consecutive patients who underwent UAS before guideline implementation (intervention). the after period included consecutive patients after guideline implementation. Patients in the pre-intervention period were submitted to a program of physical therapy in which the treatment planning was based on the individual experience of each professional. On the other hand, patients who were included in the post-intervention period underwent a standardized program of physical therapy with a focus on the use of additional strategies (EPAP, incentive spirometry and early mobilization).Results: There was a significant increase in the use of incentive spirometry and positive expiratory airway pressure after guideline implementation. Moreover, it was observed that early ambulation occurred in all patients in the post-intervention period. No patient who adhered totally to the guideline in the post-intervention period developed atelectasis. Individuals in the post-intervention period presented a shorter length of hospital stay (9.2 +/- 4.1 days) compared to patients in the pre-intervention period (12.1 +/- 8.3 days) (p< 0.05).
Somente Metadadados
Influence of dressing application time after breast augmentation on cutaneous colonization: A randomized clinical trial
(Elsevier Sci Ltd, 2018) Mendes, Denise de Almeida [UNIFESP]; Veiga, Daniela Francescato [UNIFESP]; Veiga-Filho, Joel [UNIFESP]; Loyola, A. B. A. T.; Paiva, L. F.; Novo, Neil Ferreira [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Ferreira, L. M. [UNIFESP]
Concepts regarding the best way to treat a surgical wound vary, in literature, ranging from no dressing use to dressing maintenance for 24 to 48 hours or until suture removal. This study aimed to evaluate the influence of the length of dressing maintenance after breast augmentation with implants on cutaneous colonization and surgical site infection. This is a two-arm, parallel group, randomized clinical trial. Eighty patients who were candidates for augmentation mammoplasty with silicone implants were randomly allocated to two groups, in which the dressing was removed on postoperative day 1 (group A, n = 40) or postoperative day 6 (group B, n = 40). Cutaneous colonization was examined by culturing samples collected before and after dressing removal. The criteria defined by the Centers for Disease Control and Prevention were used to assess surgical site infection. No significant difference regarding cutaneous colonization was observed between groups before dressing application. On postoperative day 6, significantly more bacterial growth was observed in group A (p = 0.01). No surgical site infection occurred. We concluded that maintaining the dressing for 6 days led to a lower cutaneous colonization but did not influence surgical site infection rates. (c) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
Acesso aberto (Open Access)
Intervenção educativa para o automonitoramento da drenagem contínua no pós-operatório de mastectomia
(Universidade Federal do Rio Grande do Sul. Escola de Enfermagem, 2013-12-01) Esteves, Marcella Tardeli [UNIFESP]; De Domenico, Edvane Birelo Lopes [UNIFESP]; Petito, Eliana Louzada [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
This study assessed how well patients who had undergone breast cancer surgery monitored their continuous drainage system after receiving one-to-one instructions at the Mastology Outpatient Clinic of Hospital São Paulo at Federal University of São Paulo. Participants were 79 women who had undergone breast cancer surgery between May 2009 and March 2010, and were using a drain. It was found that the self-care training that the patients received, in addition to the strategy used in that training, had a positive effect on their self-monitoring of the continuous drainage, which prevented the drain from clogging, evinced by the percentage of patients who maintained the permeability of the drainage system (84.2%).
Acesso aberto (Open Access)
Intervenções de enfermagem para o diagnóstico de enfermagem Desobstrução ineficaz de vias aéreas
(Escola Paulista de Enfermagem, Universidade Federal de São Paulo (UNIFESP), 2005-06-01) Martins, Ivete; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Instituto Dante Pazzanese de Cardiologia Unidade Coronariana; Universidade Federal de São Paulo (UNIFESP)
The purpose of this study is to identify the nursing actions prescribed by the nurses at Instituto Dante Pazzanese de Cardiologia (IDPC) towards patients under the nursing diagnosis of ineffective airway clearence and compare them with the ones found in the Nursing Intervention Classification (NIC), whose aim is the improvement of nursing prescription for this diagnosis. This is a retrospective study, whose data source has included 435 patients' cards hospitalized from July to December 2000, analysed after the Ethics Committee on Research at IDPC. The prescribed nursing actions are following: to perform inhalation, stimulate de ambulation, to seat the patient on an armchair, stimulate cough, stimulate hydrical intake, aspirate endotracheal cannule, observe the respiratory pattern and oxygen saturation, as well as the cyanosis of the limbs, and perform pulmonary auscultation. Some convergences along with NIC have been found, such as: to facilitate the secretion remotion by means of hydratation, the patient mobilization, stimulation to the cough, secretion aspiration and control/monitorization of the respiratory condition. The actions prescribed by the nurses are regarded to be of concern, however, detailing is in lack for the purpose of improving the guidance of their performance.
Acesso aberto (Open Access)
Programa de exercícios para mulheres submetidas à cirurgia por câncer de mama
(Universidade Federal de São Paulo (UNIFESP), 2011-11-24) Petito, Eliana Louzada [UNIFESP]; Gutiérrez, Maria Gaby Rivero de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Post-operative exercises of breast cancer are considered essentials for recovery upper limb function, enabling the continuity of treatment and return to activities of daily living. However, there are differences in the literature about the onset, types of exercises and follow-up period. The aim of this research were: to establish an extramural, early exercise program for women in postoperative (PO) of breast cancer; evaluate the effectiveness of this program; verify the time necessary to recovery of range of motion (ROM) of PO homolateral shoulder; determine the influence of the variables: type of surgery, axillary dissection and age in the recovery of ROM; relate the beginning of the program with the incidence of seroma and dehiscence and measure the adherence of these women to the program. The results showed that the program was effective for the functional recovery of ROM, and the minimum time required for recovery was 75 days for women who underwent quadrantectomy, and 105 days for mastectomized women or with axillary dissection. There was no statistically significant difference between the seroma formation (p> 0.999) or dehiscence (p> 0.999) compared women who started the program in the 1st postoperative day (PO) with those that began after the drain removal, and the early start provided a fast recovery of ROM. Concluded that the extramural program, consisting of a set of nine exercise and started in the 1st PO enables that women with difficult to attend weekly in clinical sessions obtain the functional movement of upper limb, in a period of 75 to 105 days of PO, according to the type of surgery, without increase the incidence of the two postoperative complications analyzed.
Acesso aberto (Open Access)
Projeto ORIGAMI - racionalizando a enfermaria da ginecologia
(Universidade Federal de São Paulo (UNIFESP), 2017-08-31) Uyeda, Maria Gabriela Baumgarten Kuster [UNIFESP]; Sartori, Marair Gracio Ferreira [UNIFESP]; http://lattes.cnpq.br/2545470341657690; http://lattes.cnpq.br/5253465122709463; Universidade Federal de São Paulo (UNIFESP)
Objetivo: Criar, implantar e avaliar um programa de atendimento e de otimização de cuidados perioperatórios na Enfermaria da Ginecologia. Métodos: Foram incluídas 1010 pacientes internadas consecutivamente na enfermaria da Ginecologia do Hospital São Paulo – EPM/UNIFESP divididas em 3 fases. Fase I: coleta de dados, Fase II: verificação das alterações e otimizações necessária – criação do projeto, fase III: implantação do projeto e coleta dos dados. Foram comparados os dados das fases I e III com testes t de student, de Mann Whitney e qui-quadrado. Resultados: Houve sucesso na criação e implantação do protocolo de fast track, atingindo objetivos secundários como a redução do tempo total de internação, tendência a redução do número de complicações e melhorias no pré e pós-operatório das pacientes internadas. Conclusão: É possível implementar protocolos de melhoria perioperatória com sucesso em uma enfermaria de ginecologia
Acesso aberto (Open Access)
Tempo de permanência do curativo após mamoplastia redutora: influência na colonização, na infecção da ferida operatória e na opinião das pacientes
(Universidade Federal de São Paulo (UNIFESP), 2010-08-25) Veiga Filho, Joel [UNIFESP]; Sabino Neto, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
Background: There is controversy in the literature regarding the treatment of surgical wounds, which includes different approaches to wound management, such as “not to dress the wound” to “leave the dressing in place for 24-48 hours” or “until sutures are removed”. Objective: To evaluate the effect of the length of time the dressings were left in place after reduction mammaplasty on skin colonization, surgical site infection, and patient opinion. Methods: Seventy patients undergoing reduction mammaplasty were randomly divided into two groups: group PO1 (dressing was removed on the first postoperative day) and group PO6 (dressing was removed on the sixth postoperative day). Skin colonization was detected by culture of samples collected at predefined time points. Surgical site infections were classified according to the guidelines of the Centers for Disease Control and Prevention (CDC). Patient satisfaction was assessed on postoperative day 13. Results: A larger number of colony-forming units were measured in group PO1 on postoperative day 6. Nine (12.9%) patients had surgical site infection (seven from group PO1, and two from group PO2). In group PO1, 66% of the patients chose to keep the dressing for one day, while 83% of the patients in group PO6 chose to keep the dressing for six days. Conclusions: Higher colonization levels were observed in group PO1 on the sixth postoperative day. There was no difference in surgical site infection between groups. Most of the patients chose to keep the dressing in place for six days postoperatively, and felt it was safer.

Navegando por Palavras-chave "Postoperative care"

Resultados por página

Opções de Ordenação