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Abstract

RIASSUNTO

Le infezioni del sito chirurgico rappresentano ancora oggi un problema aperto, con prolungamento dei tempi di degenza e relativo aumento dei costi sanitari ed assicurativi. La recente letteratura evidenzia come il triclosan® possa essere utilizzato con sicurezza per ridurre l'incidenza di infezioni. In questo studio vengono confrontati due gruppi di pazienti sottoposti in regime di elezione a chirurgia "pulita". Il follow up, condotto trenta giorni dopo l'intervento chirurgico attraverso intervista telefonica, come da protocollo del Sistema Nazionale di sorveglianza delle infezioni del sito chirurgico, ha mostrato migliori outcomes, anche se non statisticamente significativi, in termini di prevenzione del sito chirurgico, utilizzando le suture con antibatterico rispetto a quelle standard.

Parole chiave: infezioni del sito chirurgico, sicurezza, gestione del rischio


Comparison between antibacterial coated suture vs standard suture to prevent the surgical site infections

ABSTRACT

The surgical site infections (SSI) still represent an issue, which causes prolonged hospital staying, major costs for both healthcare system and professional insurance. Recent studies enlighten that using the antibacterial agent triclosan® leads to decrease infections rates. In this observational study we compared two groups of patients undergoing scheduled the so called clean surgery. The absence of SSI was assessed in all patients, 30 days later the surgery, through a telephone interview as indicated by the National Group for SSI surveillance protocol. The use of antibacterial sutures shows to be successful in preventing the SSI in comparison to standard sutures, even if results are not statistically significant.

Keywords: surgical site infections, safety management, risk management

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Come citare
Palma, E., Brocanelli, N., Luconi, A., & Cicolini, G. (2013). Confronto tra sutura con antibatterico vs sutura standard nella prevenzione delle infezioni del sito chirurgico. PROFESSIONI INFERMIERISTICHE, 66(1). Recuperato da https://www.profinf.net/pro3/index.php/IN/article/view/13
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Riferimenti

  • Agenzia Regionale della Sanití , Regione Friuli Venezia Giulia, Ferita chirurgica (2002). Report Regionale 2000/2001. Data accesso 16 ottobre 2010, da: http://www.snlg-iss.it/cms/files/PNLG_antib_impa.pdf
  • Anaya, D.A.& Dellinger, E.P. (2006) The obese surgical patient: a susceptible host for infection. Surgical Infections (Larchmt) 7(5): 473-80.
  • Centers for Disease Control and Prevention, National Center for Health Statistics Vital and Health Statistics, Detailed diagnoses and procedures national hospital discharge survey 1994 (1997). Vol 12 7. Hyattsville (MD): Department of Health and Human Services, 1997.
  • Centro nazionale per la prevenzione e il Controllo delle Malattie (Ccm). Sorveglianza, prevenzione e controllo. Infezioni correlate all'assistenza. Sicurezza del paziente: il rischio infettivo (2008-2010). Sistema Nazionale Sorveglianza Delle Infezioni Del Sito Chirurgico – Protocollo. ASSR Emilia-Romagna, Bologna, novembre 2009. Data accesso 6 gennaio 2012, da: asr.regione.emilia-romagna.it/.../CCM_Protocollo _ISC_11_09.pdf Simili
  • Chang, W.K., Srinivasa, S., Morton, R. & Hill A.G. (2012) Triclosan-impregnated sutures to decrease surgical site infections: systematic review and meta-analysis of randomized trials. Annals of Surgery, 255(5):854-9.
  • 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.
  • Delgado-Rodriguez , M., Medina-Cuadros, M., Martí­nez-Gallego, G, Gómez-Ortega, A., Mariscal-Ortiz, M., Palma-Pérez, S. & Sillero-Arenas, M. (2003) A prospective study of tobacco smoking as a predictor of complications in general surgery. Infection Control and Hospital Epidemiology, 24(1): 37-43.
  • Dellinger, E.P. (2001) Preventing surgical-site infections: the importance of timing and glucose control. Infection Control and Hospital Epidemiology, 22(10): 604-6.
  • Edmiston Jr, C.E., Candace, J., Krepel, P., Wilson, J., Grahn, F.B., Sadenwasser, P.J., Welter, D.L. & Seabrook, G.R. (2008) Reducing the risk of surgical site infections: embracing basic and innovative risk reduction strategies, Healthcare Infection,13(4) -121
  • Fiorio, M., Marvaso, A., Viganò, F. & Marchetti, F. (2006) Incidence of surgical site infections in general surgery in Italy. Infection 2006; 34(6): 310-4.
  • Ford, H.R., Jones, P., Gaines, B., Reblock, K. & Simpkins, D.L. (2005) Intraoperative Handling and Wound Healing: Controlled Clinical Trial Comparing Coated VICRYL® Plus Antibacterial Suture (Coated Polyglactin 910 Suture with Triclosan) with Coated VICRYL® Suture (Coated Polyglactin 910 Suture), Surgical Infections, 6(3):313-321
  • Galal, I. & El-Hindawy, K. (2011) Impact of using triclosan-antibacterial sutures on incidence of surgical site infection. American Journal of Surgery, 202(2):133-8. Epub 2011 May 19.
  • Gaynes, R.P, Culver, D.H., Horan, T.C., Edwards, J.R., Richards, C. & Tolson, J.S.(2001) Surgical site infection (SSI) rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clinical Infectious Disease 1; 33 (Suppl 2): S69-77.
  • Heger, U., Voss, S., Knebel, P., Doerr-Harim, C., Neudecker, J., Schuhmacher, C., Faist, E., Diener, M.K., Kieser, M. &
  • Seiler, C.M. (2011) Prevention of abdominal wound infection (PROUD trial, DRKS00000390): study protocol for a randomized controlled trial. Trials, 21, 12:245.
  • Horan, T.C., Gaynes, R.P., Martone, W.J., Jarvis, W.R. & Emori, T.G. (1992) CDC definitions of nosocomial surgical site infections 1992: a modification of CDC definitions of surgical wound infections. Infection Control and Hospital Epidemiology,13(10): 606-8.
  • Huszár, O., Baracs, J., Tóth, M., Damjanovich, L., Kotán, R., Lázár, G., Mán, E., Baradnai, G., Oláh, A., Benedek-Tóth, Z., Bogdán-Rajcs, S., Zemanek, P., Oláh, T.,Somodi, K., Svébis, M., Molnár, T. & Horváth, í–.P. (2012) Comparison of wound infection rates after colon and rectal surgeries using triclosan-coated or baresutures -- a multi-center, randomized clinical study. Magyar Sebészet Jun;65(3):83-91.
  • Improving patient safety in Europe Data accesso 6 gennaio 2012, da: http://helics.univ-lyon1.fr/documents/ documents.htm
  • Istituto Superiore di Sanití - Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute (2011). Infezioni correlate all'assistenza, aspetti epidemiologici. Aggiornato in data martedí¬ 6 settembre 2011. Data accesso 5 novembre 2012, da: http://www.epicentro.iss.it/problemi/infezioni_correlate/epid.asp
  • Kirkland, K.B., Briggs, J.P., Trivette, S.L., Wilkinson, W.E. & Sexton, D.J. (1999) The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infection Control and Hospital Epidemiology;20(11): 725-30.
  • Lanini, S., Jarvis, W.R., Nicastri, E., Privitera, G., Gesu, G., Marchetti, F., Giuliani, L., Piselli, P., Puro, V., Nisii, C., Ippolito, G. & INF-NOS Study Group (Gruppo Italiano per lo Studio delle Infezioni Noscomiali) (2009) Healthcare-associated infection in Italy: annual point-prevalence surveys, 2002-2004. Infection Control and Hospital Epidemiology, 30(7):659-65.
  • Laas, E., Poilroux, C., Bézu, C., Coutant, C., Uzan, S., Rouzier, R. & Chéreau, E. (2012) Antibacterial-coated suture in reducing surgical site infection in breast surgery: a prospective study. International Journal of Breast Cancer: 819578.
  • Leaper, D. (2010) Risk Factors for and Epidemiology of Surgical Site Infections, Surgical Infections, 11(3): 283-287
  • Leaper, D., Assadian, O., Hubner, N.O., McBain, A., Barbolt, T., Rothenburger, S. & Wilson, P. (2011) Antimicrobial sutures and prevention of surgical site infection: assessment of the safety of the antiseptic triclosan. International Wound Journal, 8(6):556-66.
  • Mangram, A. J., Horan, T. C. & Pearson, M. L. (1999) CDC Guideline for prevention of surgical site infection. Infections Control and Hospital Epidemiology, 20(4), 247-278
  • Martinelli, D. & Germinario, C. (2009) Epidemiologia delle infezioni del sito chirurgico, Annali di Igiene, 21 (Suppl. 1): 3-7
  • Monge Jodra, V, Sainz de Los Terreros Soler, L., Diaz-Agero Perez, C., Saa Requejo, C.M. & Plana Farras, N. (2006) Excess length of stay attributable to surgical site infection following hip replacement: a nested case-control study. Infections Control and Hospital Epidemiology; 27(12): 1299-303.
  • Moro, M.L., Petrosillo, N. & Siepi, G. (2001) Indagine conoscitiva nazionale sulle attivití di sorveglianza e controllo delle infezioni ospedaliere negli ospedali pubblici italiani. Rapporti ISTISAN. Data accesso 15 gennaio 2011, da: http://asr.regione.emilia-romagna.i/wcm/asr/aree_di_programma/rischioinfettivo/gr_ist/pr_inf_ccm/pubblicazioni/pr_infoss/link/giio2007_infoss.pdf
  • Moro, M.L., Petrosillo, N., Gandin, C. & Bella, A. (2004) Infection control and hospital epidemiology in Italian hospitals: the official journal of the Society of Hospital Epidemiologists of America, 25(1): 36-40
  • Nicastri, E., Petrosillo, N., Martini, L., Larosa, M., Gesu, G.P., Ippolito, G. & INF-NOS Study Group (2003) Prevalence of nosocomial infections in 15 Italian hospitals: first point prevalence study for the INF-NOS project. Infection, 31 (Suppl 2): 10-5.
  • Nichols, R.L. (2001) Preventing Surgical Site Infections: A Surgeon's Perspective. Emerging Infectious Diseases, 7(2): 220-4.
  • Olsen, M.A., Chu-Ongsakul, S., Brandt, K.E., Dietz, J.R., Mayfield, J. & Fraser V.J. (2008) Hospital-associated costs due to surgical site infection after breast surgery. Archives of Surgery, 143(1): 53-60; discussion 61.
  • Owens, C.D. & Stoessel, K. (2008) Surgical site infections: epidemiology, microbiology and prevention. Journal of Hospital Infection, 70 (Suppl 2):3-10.
  • Owens, W.D., Felts, J.A. & Spitznagel, E.L. Jr. (1978) ASA physical status classifications: a study of consistency of ratings. Anesthesiology, 49(4): 239-43.
  • Petrosillo, N., Drapeau, C.M., Nicastri, E., Martini, L.,
  • Ippolito, G., Moro, M.L. & ANIPIO (2008) Surgical site infections in Italian Hospitals: a prospective multicenter study. BMC Infectious Diseases, 8: 34.
  • Reilly, J., Allardice, G., Bruce, J., Hill, R. & Mc Coubrey, J. (2006) Procedure-specific surgical site infection rates and post discharge surveillance in Scotland. Infections Control and Hospital Epidemiology, 27(12): 1318-23.
  • Storch, M., Scalzo, H., Van Lue, S. & Jacinto, G. (2002) Physical and functional comparison of Coated VICRYL* Plus Antibacterial Suture (coated polyglactin 910 suture with triclosan) with Coated VICRYL* Suture (coated polyglactin 910 suture). Surgical Infections (Larchmt), 3 Suppl 1:S65-77.
  • Wang, Z.X., Jiang, C.P., Cao, Y. & Ding, Y.T. (2013) Systematic review andmeta-analisis of triclosan-coated sutures for the prevention surgical-site infection. British Journal of Surgery, 100(4):465-73.
  • Williams, N., Sweetland, H., Goyal, S., Ivins, N. & Leaper DJ. (2011) Randomizedtrial of antimicrobial-coated sutures to prevent surgical site infections after breast cancer surgery. Surgical Infections (Larchmt), 12(6):469-74.
  • Williams, M. (2008) Infection control and prevention in perioperative practice, Journal of perioperative practice, 18(7), 274-8.