Comparación de drenajes tubulares y cierre primario de heridas sucias en pacientes quirúrgicos. Hospitales Vicente Corral Moscoso y José Carrasco Arteaga. 2013

Abstract

The presence of a surgical infection should be considered a complication of great importance from the biological and economic, causes of morbidity and mortality, and these important issues to consider in health institutions. (1)

Objective: to determine the benefit of using more tubular drains primary closure in contaminated wounds compared with that using a local management of the wound with saline plus tertiary wound closure.

Materials and method: experimental study, we considered a sample of 114 with surgically dirty wound, half were placed a drain tube and primary closure (group 1), and the other half pressure washing performed with saline and tertiary closure (group 2).

Results: the most affected age group was 36-45 years in both groups. The surgical time of >2 hours was 64,91% in the study group 1, group 2 of 56,14%. Surgical site infection occurred in 5,26 % of patients in group 1 and in group 2 was 36,84% of patients. Hospital stay in group 1 had predominantly in the range of 5-6 days with a 59,65% while in group 2 the predominant range was increased to 7 days with a 50, 88%. In group 1, the relative risk (RR) with presence of surgical site infection was 0, 14(IC95% 0.05-0.45), the absolute risk reduction (ARR) of 0, 316 and in relation to bacterial load > 105 was 0, 16(IC95% 0.05-0.50), the ARR de 0,281. The number needed to treat (NNT) is 3,558.

Discussion: the null hypothesis is rejected, the alternative hypothesis is accepted

Conclusion: the use of tubular drainage and primary closure in dirty wounds is a safe and effective method to reduce the risk of surgical site infection.

KEYWORDS: WOUND INFECTION, TECHNICAL WOUND CLOSURE, THERAPY NEGATIVE PRESSURE WOUND