Surgical complexity score as a predictor of surgical site infection in dentoalveolar surgeries
DOI:
https://doi.org/10.33448/rsd-v12i7.42391Keywords:
Infection of surgical wound; Oral surgery; Third molar.Abstract
Introduction: Postoperative surgical site infections represent one of the most frequent complications related to health care and can increase morbidity and mortality, in addition to increasing treatment costs. Objectives: This study evaluated surgical site infections incidence after dentoalveolar surgeries of retained third molars. The article presents the development of a surgical complexity score that can be used as a predictive method for surgical site infections risk in dentoalveolar surgeries. Methodology: In this cross-sectional observational study, the sample was obtained for convenience, from medical records of patients diagnosed with tooth retention and who underwent dentoalveolar surgery of third molars, from 2015 to 2020. Demographic variables of patients, characteristics of the surgery and information regarding the diagnosis of surgical site infections in the postoperative period were collected. Results: A total of 360 medical records were analyzed, with 59 surgical site infection cases diagnosed (16.4%). There was a statistical difference (p<0.05) in the bivariate analysis correlating infection with time of procedure, type of incision and performance of ostectomy and tooth sectioning. Logistic regression analysis to identify the probability of infection showed no significance for any of the individual variables, except when they are combined composing the surgical complexity score, which was then significantly higher in surgical site infections cases. Conclusions: The surgical complexity score developed can be a new predictive tool for the occurrence of surgical site infections in dentoalveolar surgeries, taking into account that the greater the complexity of surgery, the greater risk.
References
Akadiri, O. A., & Obiechina, A. E. (2009). Assessment of difficulty in third molar surgery--a systematic review. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 67(4), 771–774.
Al-Asfour A. (2009). Postoperative infection after surgical removal of impacted mandibular third molars: an analysis of 110 consecutive procedures. Medical principles and practice: international journal of the Kuwait University, Health Science Centre, 18(1), 48–52.
Bailey, E., Kashbour, W., Shah, N., Worthington, H. V., Renton, T. F., & Coulthard, P. (2020). Surgical techniques for the removal of mandibular wisdom teeth. The Cochrane database of systematic reviews, 7(7), CD004345.
Bali, A., Bali, D., Sharma, A., & Verma, G. (2013). Is Pederson Index a True Predictive Difficulty Index for Impacted Mandibular Third Molar Surgery? A Meta-analysis. Journal of maxillofacial and oral surgery, 12(3), 359–364.
Benediktsdóttir, I. S., Wenzel, A., Petersen, J. K., & Hintze, H. (2004). Mandibular third molar removal: risk indicators for extended operation time, postoperative pain, and complications. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 97(4), 438–446.
Carvalho, R. L. R., Campos, C. C., Franco, L. M. C., Rocha, A. M., & Ercole, F. F. (2017). Incidence and risk factors for surgical site infection in general surgeries. Revista latino-americana de enfermagem, 25, e2848.
Chiapasco, M., De Cicco, L., & Marrone, G. (1993). Side effects and complications associated with third molar surgery. Oral surgery, oral medicine, and oral pathology, 76(4), 412–420.
Chuang, S. K., Perrott, D. H., Susarla, S. M., & Dodson, T. B. (2007). Age as a risk factor for third molar surgery complications. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 65(9), 1685–1692.
Coulthard, P., Bailey, E., Esposito, M., Furness, S., Renton, T. F., & Worthington, H. V. (2014). Surgical techniques for the removal of mandibular wisdom teeth. The Cochrane database of systematic reviews, (7), CD004345.
da Cunha, B. M., de Oliveira, S. B., & Santos-Neto, L. (2011). Incidence of infectious complications in hip and knee arthroplasties in rheumatoid arthritis and osteoarthritis patients. Revista brasileira de reumatologia, 51(6), 609–615.
Delgado-Rodríguez, M., Gómez-Ortega, A., Sillero-Arenas, M., & Llorca, J. (2001). Epidemiology of surgical-site infections diagnosed after hospital discharge: a prospective cohort study. Infection control and hospital epidemiology, 22(1), 24–30.
Estrela, C. (2018). Metodologia científica: ciência, ensino, pesquisa. Artes Médicas.
Emori, T. G., Culver, D. H., Horan, T. C., Jarvis, W. R., White, J. W., Olson, D. R., Banerjee, S., Edwards, J. R., Martone, W. J., & Gaynes, R. P. (1991). National nosocomial infections surveillance system (NNIS): description of surveillance methods. American journal of infection control, 19(1), 19–35.
Figueiredo, R., Valmaseda-Castellón, E., Berini-Aytés, L., & Gay-Escoda, C. (2007). Delayed-onset infections after lower third molar extraction: a case-control study. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 65(1), 97–102.
Fisha, K., Azage, M., Mulat, G., & Tamirat, K. S. (2019). The prevalence and root causes of surgical site infections in public versus private hospitals in Ethiopia: a retrospective observational cohort study. Patient safety in surgery, 13, 26.
Fuglestad, M. A., Tracey, E. L., & Leinicke, J. A. (2021). Evidence-based Prevention of Surgical Site Infection. The Surgical clinics of North America, 101(6), 951–966.
Gibbons, C., Bruce, J., Carpenter, J., Wilson, A. P., Wilson, J., Pearson, A., Lamping, D. L., Krukowski, Z. H., & Reeves, B. C. (2011). Identification of risk factors by systematic review and development of risk-adjusted models for surgical site infection. Health technology assessment (Winchester, England), 15(30), 1–iv.
Kaye, K. S., Sands, K., Donahue, J. G., Chan, K. A., Fishman, P., & Platt, R. (2001). Preoperative drug dispensing as predictor of surgical site infection. Emerging infectious diseases, 7(1), 57–65.
Kirk, D. G., Liston, P. N., Tong, D. C., & Love, R. M. (2007). Influence of two different flap designs on incidence of pain, swelling, trismus, and alveolar osteitis in the week following third molar surgery. Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics, 104(1), e1–e6.
Lodi, G., Figini, L., Sardella, A., Carrassi, A., Del Fabbro, M., & Furness, S. (2012). Antibiotics to prevent complications following tooth extractions. The Cochrane database of systematic reviews, 11, CD003811.
Lodi, G., Azzi, L., Varoni, E. M., Pentenero, M., Del Fabbro, M., Carrassi, A., Sardella, A., & Manfredi, M. (2021). Antibiotics to prevent complications following tooth extractions. The Cochrane database of systematic reviews, 2(2), CD003811.
Mengistu, D. A., Alemu, A., Abdukadir, A. A., Mohammed Husen, A., Ahmed, F., Mohammed, B., & Musa, I. (2023). Global Incidence of Surgical Site Infection Among Patients: Systematic Review and Meta-Analysis. Inquiry : a journal of medical care organization, provision and financing, 60, 469580231162549.
Meyer, A. C. D. A., Lima, J. R. S., Nascimento, R. D., Moraes, M. B. D., Tera, T. D. M., & Raldi, F. V. (2011). Prevalência de alveolite após a exodontia de terceiros molares impactados. RPG. Revista de Pós-Graduação, 18(1), 28-32.
Miyazaki, R., Sukegawa, S., Nakagawa, K., Nakai, F., Nakai, Y., Ishihama, T., & Miyake, M. (2023). Risk Factors for Delayed-Onset Infection after Mandibular Wisdom Tooth Extractions. Healthcare (Basel, Switzerland), 11(6), 871.
Mohajerani, H., Esmaeelinejad, M., Jafari, M., Amini, E., & Sharabiany, S. P. (2018). Comparison of Envelope and Modified Triangular Flaps on Incidence of Dry Socket after Surgical Removal of Impacted Mandibular Third Molars: A Double-blind, Split-mouth Study. The journal of contemporary dental practice, 19(7), 836–841.
Oomens, M. A., & Forouzanfar, T. (2012). Antibiotic prophylaxis in third molar surgery: a review. Oral surgery, oral medicine, oral pathology and oral radiology, 114(6), e5–e12.
Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica.[e-book]. Santa Maria. Ed (pp. 3-9). UAB/NTE/UFSM. Disponível em: https://repositorio. ufsm. br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica. pdf.
Phan, K., Phan, P., Stratton, A., Kingwell, S., Hoda, M., & Wai, E. (2019). Impact of resident involvement on cervical and lumbar spine surgery outcomes. The spine journal: official journal of the North American Spine Society, 19(12), 1905–1910.
Ribeiro, M. M., de Oliveira, A. C., & de Jesus Braz, N. (2007). Incidência da infecção do sítio cirúrgico em um hospital universitário. Ciência, Cuidado e Saúde, 6(4), 486-493.
Rice, S., Carr, K., Sobiesuo, P., Shabaninejad, H., Orozco-Leal, G., Kontogiannis, V., Marshall, C., Pearson, F., Moradi, N., O'Connor, N., Stoniute, A., Richmond, C., Craig, D., Allegranzi, B., & Cassini, A. (2023). Economic evaluations of interventions to prevent and control health-care-associated infections: a systematic review. The Lancet. Infectious diseases, S1473-3099(22)00877-5. Advance online publication.
Sahtoe, A. P. H., Duraku, L. S., van der Oest, M. J. W., Hundepool, C. A., de Kraker, M., Bode, L. G. M., & Zuidam, J. M. (2021). Warm Weather and Surgical Site Infections: A Meta-analysis. Plastic and reconstructive surgery. Global open, 9(7), e3705.
Seidelman, J. L., Mantyh, C. R., & Anderson, D. J. (2023). Surgical Site Infection Prevention: A Review. JAMA, 329(3), 244–252.
Sukegawa, S., Yokota, K., Kanno, T., Manabe, Y., Sukegawa-Takahashi, Y., Masui, M., & Furuki, Y. (2019). What are the risk factors for postoperative infections of third molar extraction surgery: A retrospective clinical study?. Medicina oral, patologia oral y cirugia bucal, 24(1), e123–e129.
Tesini, B. L., & Dumyati, G. (2023). Health Care-Associated Infections in Older Adults: Epidemiology and Prevention. Infectious disease clinics of North America, 37(1), 65–86.
Torof, E., Morrissey, H., & Ball, P. A. (2023). The Role of Antibiotic Use in Third Molar Tooth Extractions: A Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania), 59(3), 422.
Totty, J. P., Moss, J. W. E., Barker, E., Mealing, S. J., Posnett, J. W., Chetter, I. C., & Smith, G. E. (2021). The impact of surgical site infection on hospitalisation, treatment costs, and health-related quality of life after vascular surgery. International wound journal, 18(3), 261–268.
Wilson, W. R., Gewitz, M., Lockhart, P. B., Bolger, A. F., DeSimone, D. C., Kazi, D. S., Couper, D. J., Beaton, A., Kilmartin, C., Miro, J. M., Sable, C., Jackson, M. A., Baddour, L. M., & American Heart Association Young Hearts Rheumatic Fever, Endocarditis and Kawasaki Disease Committee of the Council on Lifelong Congenital Heart Disease and Heart Health in the Young; Council on Cardiovascular and Stroke Nursing; and the Council on Quality of Care and Outcomes Research (2021). Prevention of Viridans Group Streptococcal Infective Endocarditis: A Scientific Statement From the American Heart Association. Circulation, 143(20), e963–e978.
Yokoe, D. S., Mermel, L. A., Anderson, D. J., Arias, K. M., Burstin, H., Calfee, D. P., Coffin, S. E., Dubberke, E. R., Fraser, V., Gerding, D. N., Griffin, F. A., Gross, P., Kaye, K. S., Klompas, M., Lo, E., Marschall, J., Nicolle, L., Pegues, D. A., Perl, T. M., Podgorny, K., & Classen, D. (2008). A compendium of strategies to prevent healthcare-associated infections in acute care hospitals. Infection control and hospital epidemiology, 29 Suppl 1, S12–S21.
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Copyright (c) 2023 Amália Pletsch Furlanetto; Leandro Rios Guidolin; Alexandre Silva de Quevedo; Daniela Müller de Quevedo; Edela Puricelli; Deise Ponzoni
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