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使用过氧乙酸对器械进行消毒时,视频腹腔镜胆囊切除术中的手术感染。

Surgical infection in a videolaparoscopic cholecystectomy when using peracetic acid for the sterilization of instruments.

作者信息

de Melo Edluza Maria Viana Bezerra, Leão Cristiano de Souza, Andreto Luciana Marques, de Mello Maria Júlia Gonçalves

机构信息

Instituto de Medicina Integral Prof. Fernando Figueira, Recife, Pernambuco, Brasil.

出版信息

Rev Col Bras Cir. 2013 May-Jun;40(3):208-14. doi: 10.1590/s0100-69912013000300008.

Abstract

OBJECTIVE

To determine the frequency of surgical site infection in patients undergoing laparoscopic cholecystectomy with instruments sterilized by peracetic acid.

METHODS

We conducted a retrospective, cohort, descriptive, cross-sectional study. Peracetic acid has been used for sterilization following the protocol recommended by the manufacturer. We observed the criteria and indicators of process and structure for preventing surgical site infection pre and intraoperatively. For epidemiological surveillance, outpatient visits were scheduled for the 15th and between the 30th and 45th days after discharge.

RESULTS

Among the 247 patients, there were two cases of surgical site infection (0.8%). One patient was readmitted to systemic antibiotic therapy and percutaneous puncture; in the other the infection was superficial and followed at the clinic.

CONCLUSION

Ethical issues prevent the conduction of a prospective study because of peracetic acid have been banned for the sterilization of instruments that penetrate organs and cavities. Nevertheless, these results encourage prospective case-control studies comparing its use (historical control) with ethylene oxide sterilization.

摘要

目的

确定使用过氧乙酸消毒器械进行腹腔镜胆囊切除术患者的手术部位感染发生率。

方法

我们开展了一项回顾性队列描述性横断面研究。按照制造商推荐的方案使用过氧乙酸进行消毒。我们在术前和术中观察了预防手术部位感染的过程和结构标准及指标。为进行流行病学监测,在出院后第15天以及第30至45天安排门诊随访。

结果

在247例患者中,有2例发生手术部位感染(0.8%)。1例患者重新入院接受全身抗生素治疗和经皮穿刺;另1例感染为表浅性,在门诊随访。

结论

由于过氧乙酸已被禁止用于穿透器官和腔隙器械的消毒,伦理问题阻碍了前瞻性研究的开展。尽管如此,这些结果鼓励开展前瞻性病例对照研究,将其使用情况(历史对照)与环氧乙烷消毒进行比较。

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