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Abstract
Riassunto
Background: L'incidenza delle infezioni della ferita (SSIs) nelle pazienti sottoposte a chirurgia senologica è del 3.1% . Il rischio di sviluppare SSIs sembra sia correlato al livello di innalzamento della glicemia. Materiali e metodi: La finalití di questo lavoro è quella di valutare attraverso uno studio longitudinale prospettico se vi è correlazione tra i valori glicemici e SSIs nelle pazienti sottoposte a chirurgia senologica. Questo lavoro, effettuato nel Dipartimento Chirurgico di una Azienda Ospedaliero Universitaria Friulana, si inserisce nel contesto del programma di Sorveglianza Regionale indetto dalla Agenzia Regionale della Sanití . Il campione è di convenienza. Risultati: Sono state prese in considerazione 100 pazienti. L'incidenza delle SSIs è del 5.7%. Le pazienti che hanno sviluppato le SSIs sono tutte in ricovero ordinario, Si riscontra in queste pazienti un valore glicemico mediamente più alto rispetto alle pazienti senza SSIs sia in fase pre (92.6 vs 88.5; p>0.05) che post operatoria (104 vs 91.8 e 108.3 vs 94; p<0.05). Conclusioni: Non è stata dimostrata alcuna correlazione tra valori glicemici e SSIs visto anche la consistenza del campione. Tuttavia dal punto di vista della pratica clinica ci sono importanti indicazioni di comportamento.
Parole chiave: Infections, Breast Neoplasms, Hyperglycemia, Diabetes Mellitus, Blood Glucose.
Abstract
Background: The incidence of postoperative surgical site infections (SSIs) in breast surgery is 3.1%. The risk to develop SSIs seems correlated to the level of glycemia. Materials and methods: The aim is to test a correlation between glycemic values and SSIs in breast surgery with a longitudinal perspective study. The data were collected in a Surgical Department of a University Hospital of north-east Italy; the study is in the context of the Regional Surveillance Program of Health Agency. Results: We have observed 100 patients. The incidence of the SSIs has been 5.7%. The patients that have developed the SSIs were in ordinary recovery, with a glycemic value taller then the patients without SSIs both in preoperative (92.6 vses 88.5; p>0.05) that in postoperative period (104 vses 91.8 and 108.3 vses 94; p < 0.05). Conclusions:"ˆWe cannot test a correlation between SSIs and glycemic value nevertheless for the clinical practice we have important guideline.
Key words: Infections, Breast Neoplasms, Hyperglycemia, Diabetes Mellitus, Blood Glucose.
Dettagli dell'articolo
Riferimenti
- Collier, B., Diaz J, Jr., Forbes, R., Morris J, Jr., May,A., Guy, J., Ozdas, A., Dupont, W., Miller, R., & Jensen, G. (2005). The impact of a normoglycemic management protocol on clinical outcomes in the trauma intensive care unit. Journal of Parenteral Enteral Nutrition, 29, 353–358.
- Furnary, AP., Wu, Y., & Bookin, SO. (2004). Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocrinological Practice, 10 (2), 21–33.
- Grey, NJ., & Perdrizet, GA. (2004). Reduction of nosocomial infections in the surgical intensive-care unit by strict glycemic control. Endocrinological Practice, 10 (2), 46–52.
- Hanazaki, K., Maeda, H., & Okabayashi, T. (2009). Relationship between perioperative glycemic control and postoperative infections. World Journal of Gastroenterology, 15 (33), 4122-4125.
- Kao LS, Meeks D, Moyer VA, Lally KP. (2009) Peri-operative glycaemic control regimens for preventing surgical site infections in adults. Cochrane Database Systematic Review Jul 8;(3).
- Marchant, MH. Jr., Viens, NA., Cook, C., Vail, TP., & Bolognesi,
- MP. (2009). The impact of glycemic control and diabetes mellitus on perioperative outcomes after total arthroplasty. Journal of Bone and Joint Surgery, American volume, 91 (7):1621-1629.
- Tanner J, Norrie P, Melen K. (2011) Preoperative hair removal to reduce surgical site infection. Cochrane Database Systematic Review. Nov 9;(11).
- Xue DQ, Qian C, Yang L, Wang XF. (2012). Risk factors for surgical site infections after breast surgery: a systematic review and meta-analysis. European Journal of Surgical Oncology, 38 (5), 375-81.
Riferimenti
Collier, B., Diaz J, Jr., Forbes, R., Morris J, Jr., May,A., Guy, J., Ozdas, A., Dupont, W., Miller, R., & Jensen, G. (2005). The impact of a normoglycemic management protocol on clinical outcomes in the trauma intensive care unit. Journal of Parenteral Enteral Nutrition, 29, 353–358.
Furnary, AP., Wu, Y., & Bookin, SO. (2004). Effect of hyperglycemia and continuous intravenous insulin infusions on outcomes of cardiac surgical procedures: the Portland Diabetic Project. Endocrinological Practice, 10 (2), 21–33.
Grey, NJ., & Perdrizet, GA. (2004). Reduction of nosocomial infections in the surgical intensive-care unit by strict glycemic control. Endocrinological Practice, 10 (2), 46–52.
Hanazaki, K., Maeda, H., & Okabayashi, T. (2009). Relationship between perioperative glycemic control and postoperative infections. World Journal of Gastroenterology, 15 (33), 4122-4125.
Kao LS, Meeks D, Moyer VA, Lally KP. (2009) Peri-operative glycaemic control regimens for preventing surgical site infections in adults. Cochrane Database Systematic Review Jul 8;(3).
Marchant, MH. Jr., Viens, NA., Cook, C., Vail, TP., & Bolognesi,
MP. (2009). The impact of glycemic control and diabetes mellitus on perioperative outcomes after total arthroplasty. Journal of Bone and Joint Surgery, American volume, 91 (7):1621-1629.
Tanner J, Norrie P, Melen K. (2011) Preoperative hair removal to reduce surgical site infection. Cochrane Database Systematic Review. Nov 9;(11).
Xue DQ, Qian C, Yang L, Wang XF. (2012). Risk factors for surgical site infections after breast surgery: a systematic review and meta-analysis. European Journal of Surgical Oncology, 38 (5), 375-81.