Score de complejidad quirúrgica como predictor de infección del sitio quirúrgico en cirugías dentoalveolares

Autores/as

DOI:

https://doi.org/10.33448/rsd-v12i7.42391

Palabras clave:

Infección de la herida quirúrgica; Cirugía bucal; Tercer molar.

Resumen

Introducción: Las infecciones del sitio quirúrgico posoperatorio representan una de las complicaciones más frecuentes relacionadas con el cuidado de la salud y pueden aumentar la morbimortalidad, además de incrementar los costos del tratamiento. Objetivos: Este estudio evaluó la incidencia de infecciones del sitio quirúrgico después de cirugías dentoalveolares de terceros molares retenidos. El artículo presenta el desarrollo de un score de complejidad quirúrgica que puede ser utilizado como método predictivo del riesgo de infecciones del sitio quirúrgico en cirugías dentoalveolares. Metodología: En este estudio observacional de corte transversal, la muestra se obtuvo por conveniencia, de las historias clínicas de los pacientes con diagnóstico de retención dental y que se sometieron a cirugía dentoalveolar de terceros molares, del 2015 al 2020. Variables demográficas de los pacientes, características de la cirugía y se recolectó información sobre el diagnóstico de infecciones del sitio quirúrgico en el postoperatorio. Resultados: Se analizaron un total de 360 historias clínicas, diagnosticándose 59 casos de infección del sitio quirúrgico (16,4%). Hubo diferencia estadística (p<0,05) en el análisis bivariado que correlacionó la infección con el tiempo del procedimiento, el tipo de incisión y la realización de la ostectomía y la odontosección. El análisis de regresión logística para identificar la probabilidad de infección no mostró significación para ninguna de las variables individuales, excepto cuando se combinan para componer el puntaje de complejidad quirúrgica, que luego fue significativamente mayor en los casos de infecciones del sitio quirúrgico. Conclusiones: El score de complejidad quirúrgica desarrollado puede ser una nueva herramienta predictiva para la ocurrencia de infecciones del sitio quirúrgico en cirugías dentoalveolares, teniendo en cuenta que a mayor complejidad de la cirugía mayor riesgo.

Citas

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.

Descargas

Publicado

13/07/2023

Cómo citar

FURLANETTO, A. P. .; GUIDOLIN, L. R. .; QUEVEDO, A. S. de .; QUEVEDO, D. M. de .; PURICELLI, E.; PONZONI, D. Score de complejidad quirúrgica como predictor de infección del sitio quirúrgico en cirugías dentoalveolares. Research, Society and Development, [S. l.], v. 12, n. 7, p. e5612742391, 2023. DOI: 10.33448/rsd-v12i7.42391. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/42391. Acesso em: 17 jul. 2024.

Número

Sección

Ciencias de la salud