Dados do Trabalho

Título

Characterization of individuals affected by post-surgical infection in the nervous system in a referral hospital

Resumo

INTRODUCTION: Surgical procedures in the nervous system have a number of possible complications. In this context, the development of a surgical site infection (SSI) is capable of causing high morbidity and mortality, psychosocial impacts on the life of the infirm and their families, in addition to increasing treatment costs for the health institution. The literature related to SSI in neurosurgery is scarce. OBJECTIVE: To detect the incidence of SSI, predisposing factors and, finally, to evaluate the forms of prevention. METHOD: This is a descriptive, cross-sectional and retrospective study to assess the incidence of SSI in neurosurgery at a referral hospital in the interior of the state of São Paulo. Secondary data contained in the medical records of patients undergoing neurosurgical interventions at Hospital Santa Casa de Araraquara-SP, a tertiary referral hospital for elective and emergency procedures, from 2017 to 2020, were used. RESULT: We obtained an incidence of SSI in neurosurgeries of 6.5%, in 651 surgeries, mainly wall infection (35.9%) and ventriculitis/meningitis (35.9%). The mean age of affected individuals was 53.8 years and 79.5% of patients who developed infection had comorbidities. Elective surgeries and clean procedures had a higher frequency of infection than non-elective and potentially contaminated procedures (53.8%). Trauma and hemorrhage interventions showed a greater presence of SSI compared to other types of surgeries; 53.8% of SSIs were diagnosed during the outpatient follow-up of the patient; 66.7% of the acts used some type of drain or graft device. S. aureus was the most frequently isolated pathogen. The study showed an incidence of infection similar to other national and developing country studies, but with a higher incidence in elective surgeries, which may be related to the lack of institutional protocols in the postoperative period and neurosurgical dressings.CONCLUSION: The investigation demonstrated the need to develop institutional protocols that indicate the adoption of pre, intra and post-surgical measures, such as: use of intranasal mupirocin, meticulous aseptic technique and exchange of gloves before the placement of prostheses, as well as the maintenance of prolonged outpatient follow-up and patient guidance on surgical wound care.