Preparación de la piel para la prevención de la Infección del Sitio Operatorio: Revisión de Alcance
DOI:
https://doi.org/10.15649/cuidarte.1054Palabras clave:
Infección de Herida Quirúrgica, Antiinfecciosos Locales, Remoción del cabello, Período Preoperatorio, Prevención y ControlResumen
Introducción: La Infección del sitio operatorio genera un impacto económico y social debido a los altos costos durante la recuperación, la estancia hospitalaria y la afectación de la calidad de vida, por esto, es necesario identificar las intervenciones y recomendaciones para la preparación de la piel, encaminadas a la prevención de la infección del sitio operatorio, basado en la evidencia científica. Materiales y Métodos: Se realizó una revisión sistemática de alcance en el marco del Instituto Joanna Briggs y los parámetros Prisma-P. En las bases de datos Medline, OVID, Pubmed, Scielo, BVS y Cochrane, publicadas entre los años 2010–2019, en los idiomas inglés, portuges y español. Resultados: Se analizaron 28 artículos. De estos, se identificaron 6 de la categoría general incluidas las guías de prevención de infección del sitio operatorio, 6 para el baño preoperatorio, 6 para la realización del rasurado y 10 de asepsia y antisepsia. Discusión: Con respecto al baño preoperatorio, es una práctica recomendada internacionalmente, la evidencia demuestra que esta actividad no representa ningún beneficio; en la categoría de rasurado, la recomendación es no remover el vello a menos que sea absolutamente necesario. Frente a la asepsia del sitio quirúrgico, el aporte es más que todo informativo acerca de los antisépticos y se recomienda el uso de la clorhexidina. Conclusiones: De acuerdo a la revisión sistemática de alcance de la literatura, no se evidencia una estandarización en las recomendaciones e intervenciones, para la preparación de la piel en la prevención de Infección del Sitio Operatorio.
Como citar este artículo: Medina Garzón M, Castaño Plata María C, Moreno Herrera Cristhian C. Preparación de la piel para la prevención de la Infección del Sitio Operatorio: Revisión de Alcance. Revista Cuidarte. 2021;12(2):e1054. http://dx.doi.org/10.15649/cuidarte.1054
Referencias
Keely Boyle K, Rachala S, Nodzo SR. Centers for Disease Control and Prevention 2017 Guidelines for Prevention of Surgical Site Infections: Review and Relevant Recommendations. Curr Rev Musculoskelet Med 2018;11(3):357–69. https://doi.org/10.1007/s12178-018-9498-8
Borges EL, Pires JF, Silva Abreu MN, de Araújo Lima VL, Silva PAB, Soares SM. Factors associated with the healing of complex surgical wounds in the breast and abdomen: Retrospective cohort study. Rev Lat Am Enfermagem. 2016; 24:55.
https://doi.org/10.1590/1518-8345.1398.2811
O’Hara LM, Thom KA, Preas MA. Update to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infection (2017): A summary, review, and strategies for implementation. Am J Infect Control 2018;46(6):602–9.
https://doi.org/10.1016/j.ajic.2018.01.018
Harrington P. Prevention of surgical site infection. Nurs Stand. 2014;28(48):50–8. https://doi.org/10.7748/ns.28.48.50.e8958
Tsai DM, Caterson EJ. Current preventive measures for health-care associated surgical site infections: a review. Patient Saf Surg 2014;8(1):42. https://doi.org/10.1186/s13037-014-0042-5
Anchieta DW de, Matos FG de OA, Alves DCI, Santos RP dos, Oliveira JLC de, Dal Molin T. Caracterización de infecciones del sitio quirúrgico en un hospital público docente de la ciudad de Cascavel, Paraná. Visa em Debate. 2019;7(3):31-6. https://doi.org/10.22239/2317-269x.01277
Sociedad Española de Medicina Preventiva. Estudio Epine-Epps 2017 Según el protocolo "EPINE-Point prevalence survey of healthcare-associated infections and antimicrobial use in acute care hospitals Informe global de España. 2017.
Leaper DJ, Edmiston CE. World Health Organization: global guidelines for the prevention of surgical site infection. J Hosp Infect. 2017;95(2):135–6.
https://doi.org/10.1016/j.jhin.2016.12.016
Gould D. Causes, prevention and management of surgical site infection. Nurs Stand. 2012;26(47):47-56. https://doi.org/10.7748/ns2012.07.26.47.47.c9226
Yokoe DS, Anderson DJ, Berenholtz SM, Calfee DP, Dubberke ER, Ellingson KD, et al. A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2014 Updates. Am J Infect Control 2014;42(8):820–8.
https://doi.org/10.1016/j.ajic.2014.07.002
Milena S, Vargas R, Torres G. Informe De Evento De Infecciones Asociadas a Dispositivos, Colombia, 2018. Pág. 2 de 17.
DeBaun B. Looking Forward—Infection Prevention in 2017. AORN J. 2016;104(6):531–5. Available from: http://dx.doi.org/10.1016/j.aorn.2016.09.016
Shi D, Yao Y, Yu W. Comparison of preoperative hair removal methods for the reduction of surgical site infections: a meta-analysis, J. Clin. Nurs. 2017; 26:2907–14.
https://doi.org/10.1111/jocn.13661
Peters MDJ, Godfrey CM, Khalil H, McInerney P, Parker D, Soares CB. Guidance for conducting systematic scoping reviews. Int J Evid Based Healthc. 2015;13(3):141–6. https://doi.org/10.1097/XEB.0000000000000050
Hutton B, Catalá-López F, Moher D. La extensión de la declaración PRISMA para revisiones sistemáticas que incorporan metaanálisis en red: Prisma-Nma. Med Clin 2016;147(6):262–6. https://doi.org/10.1016/j.medcli.2016.02.025
Khalil H, Peters M, Godfrey CM, Mcinerney P, Soares CB, Parker D. An Evidence-Based Approach to Scoping Reviews. Worldviews on Evidence-Based Nurs. 2016;13(2):118–23. https://doi.org/10.1111/wvn.12144
Zeng X, Zhang Y, Kwong JSW, Zhang C, Li S, Sun F, et al. The methodological quality assessment tools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: A systematic review. Journal of Evidence-Based Medicine. 2015; 8:2–10. http://doi.wiley.com/10.1111/jebm.12141
Lenzen SA, Daniëls R, Van Bokhoven MA, Van Der Weijden T, Beurskens A. Disentangling self-management goal setting and action planning: A scoping review. Plos One. 2017;12(11): e0188822. https://doi.org/10.1371/journal.pone.0188822
Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, et al. Amstar 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017; 358:1-9. https://doi.org/10.1136/bmj.j4008.
De G, Clínica En P, Sns EL. Guía de Práctica Clínica para la Seguridad del Paciente Quirúrgico. Madrid: Ministerio de Sanidad, Servicios Sociales e Igualdad 2010.
Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2015;35(6):605-627. https://dx.doi.org/10.1086%2F676022
The Canadian Patient Safety Insitute. Prevent Surgical Site Infections. Getting Started Kit. 2014. Available from: www.saferhealthcarenow.ca
National Services Scotland. Targeted literature review: What are the key infection prevention and control recommendations to inform a surgical site infection (SSI) prevention quality improvement tool? of existing infection prevention and control quality improvement tools to ensure ongoing need and fitness for purpose. 2012; Available from: https://www.documents.hps.scot.nhs.uk/hai/infection-control/evidence-for-care-bundles/literature-reviews/ssi-review.pdf.
Leaper DJ, Edmiston CE. World Health Organization: global guidelines for the prevention of surgical site infection. J Hosp Infect. 2017;95(2):135–6
https://doi.org/10.1016/j.jhin.2016.12.016.
Berriós-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al. Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. Vol. 152, JAMA Surg. American Medical Association; 2017;152(8):784–91. Available from: https://dx.doi.org/10.1001/jamasurg.2017.0904.
Gómez-Romero FJ, Fernández-Prada M, Navarro-Gracia JF. Prevention of Surgical Site Infection: Analysis and Narrative Review of Clinical Practice Guidelines. Cir Esp. 2017;95(9):490–502.https://doi.org/10.1016/j.ciresp.2017.09.004
Webster J, Osborne S. Preoperative bathing or showering with skin antiseptics to prevent surgical site infection. Cochrane Database Syst Rev.2015;(2).
https://doi.org/10.1002/14651858.CD004985.pub5.
Franco LM de C, Cota GF, Pinto TS, Ercole FF. Preoperative bathing of the surgical site with chlorhexidine for infection prevention: Systematic review with meta-analysis. Am J Infect Control. 2017 ;45(4):343–9. Available from: https://doi.org/10.1016/j.ajic.2016.12.003.
Chlebicki MP, Safdar N, O’Horo JC, Maki DG. Preoperative chlorhexidine shower or bath for prevention of surgical site infection: A meta-analysis. Vol. 41, Am. J. Infect. Control. 2013. p. 167–73. Available from: http://dx.doi.org/10.1016/j.ajic.2012.02.014.
Zywiel MG, Daley JA, Delanois RE, Naziri Q, Johnson AJ, Mont MA. Advance pre-operative chlorhexidine reduces the incidence of surgical site infections in knee arthroplasty. Int Orthop. 2011 ;35(7):1001–6. https://doi.org/10.1007/s00264-010-1078-5
Alawadi ZM, Kao LS. Chlorhexidine Gluconate, 4%, Showers and Surgical Site Infection Reduction. Jama Surg. 2015;150(11):1033. https://doi.org/10.1001/jamasurg.2015.2219
Sebastian S. Does preoperative scalp shaving result in fewer postoperative wound infections when compared with no scalp shaving? A systematic review. J Neurosci Nurs.2012 V;44(3):149–156. https://doi.org/10.1097/JNN.0b013e31825106d2.
Lefebvre A, Saliou P, Lucet JC, Mimoz O, Keita-Perse O, Grandbastien B, et al. Preoperative hair removal and surgical site infections: network meta-analysis of randomized controlled trials. J Hosp Infect. 2015;91(2):100–8. https://doi.org/10.1016/j.jhin.2015.06.020.
Kowalski TJ, Kothari SN, Mathiason MA, Borgert AJ. Impact of Hair Removal on Surgical Site Infection Rates: A Prospective Randomized Noninferiority Trial. In: Journal of the American College of Surgeons; 2016. P:704–11.
http://dx.doi.org/10.1016/j.jamcollsurg.2016.03.032
Shi D, Yao Y, Yu W. Comparison of preoperative hair removal methods for the reduction of surgical site infections: a meta-analysis. J Clin Nurs. 2017;26(19–20):2907–14.
https://doi.org/10.1111/jocn.13661
Tanner J, Norrie P, Melen K. Preoperative hair removal to reduce surgical site infection. Cochrane Database Syst Rev. 2011;(11):CD004122.
https://dx.doi.org/10.1001/jamasurg.2017.0904
Maya JJ, Ruiz SJ, Pacheco R, Valderrama SL, Villegas MV. Papel de la clorhexidina en la prevención de las infecciones asociadas a la atención en salud. Rev. Infectio. 2011;15(2):98–107. Available from: http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S0123-93922011000200004&lng=en
Zinn J, Jenkins JB, Harrelson B, Wrenn C, Haynes E, Small N. Differences in intraoperative prep solutions: a retrospective chart review. AORN Journal. 2013;97(5):552–8.
https://doi.org/10.1016/j.aorn.2013.03.006
Charles D, Heal CF, Delpachitra M, Wohlfahrt M, Kimber D, Sullivan J, et al. Alcoholic versus aqueous chlorhexidine for skin antisepsis: The Avalanche Trial. Rev. CMAJ. 2017 8;189(31): E1008–16. https://doi.org/10.1503/cmaj.161460.
Wang Z, Zheng J, Zhao Y, Xiang Y, Chen X, Zhao F, et al. Preoperative bathing with chlorhexidine reduces the incidence of surgical site infections after total knee arthroplasty: A meta-analysis. Medicine (Baltimore). 2017;96(47): e8321.
https://doi.org/10.1097/MD.0000000000008321
Makhni MC, Jegede K, Lombardi J, Whittier S, Gorroochurn P, Lehman RA, et al. No Clear Benefit of Chlorhexidine Use at Home Before Surgical Preparation. J Am Acad Orthop Surg. 2018;26(2): e39–e47. https://doi.org/10.5435/jaaos-d-16-00866
John B, K. K. Rajith K, C. Vipinchandran. Comparison of efficacy of chlorhexidine alcohol with povidone iodine for prevention of surgical site infection: a prospective study. Int Surg J. 2018; 1668:72. https://dx.doi.org/10.18203/2349-2902.isj20181480
Darouiche RO, Wall MJ, Itani KMF, Otterson MF, Webb AL, Carrick MM, et al. Chlorhexidine-Alcohol versus Povidone-Iodine for Surgical-Site Antisepsis. The new england journal of medicine. 2010;18-26.
Available from: www.nejm.org https://doi.org/10.1056/NEJMoa0810988
Harnoss JC, Assadian O, Kramer A, Probst P, Müller-Lantzsch C, Scheerer L, et al. Comparison of chlorhexidine-isopropanol with isopropanol skin antisepsis for prevention of surgical-site infection after abdominal surgery. Br J Surg. 2018;105(7):893–9. https://doi.org/10.1002/bjs.10793.
Patrick S, McDowell A, Lee A, Frau A, Martin U, Gardner E, et al. Antisepsis of the skin before spinal surgery with povidone iodine-alcohol followed by chlorhexidine gluconate-alcohol versus povidone iodine-alcohol applied twice for the prevention of contamination of the wound by bacteria: a randomised controlled trial. The Bone Joint J. 2017;99-B (10):1354–65. https://doi.org/10.1302/0301-620X.99B10.BJJ-2017-0291.R1
Edmiston CE, Lee CJ, Krepel CJ, et al. Evidence for a standardized preadmission showering regimen to achieve maximal antisepti. Jama Surg. 2015;150(11):1027-33. https://doi.org/10.1001/jamasurg.2015.2210
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