ABSTRACT
RESUMEN Las infecciones del sitio quirúrgico constituyen un problema de calidad de los cuidados a la salud, las cuales son potencialmente prevenibles mediante la aplicación de guías de prevención basadas en evidencias. Se pretendedescribir la evolución histórica de las prácticas de uso profiláctico de antibióticos en cirugía de colon desde el siglo pasado. Se analizó literatura publicada en las últimas cinco décadas en MEDLINE, Infomed y otras fuentes secundarias. Se destaca la evolución del uso combinado de antimicrobianos (aminoglucósidos, penicilina, cefalosporinas y nitroimidazoles) asociados a la preparación enérgica del colon en la década de los 70 del pasado siglo. Numerosos antimicrobianos y prácticas han sido ensayados para demostrar que el uso de antibióticos para el control de las bacterias aerobias y anaerobias, administrados por vía oral e intravenosa, logra la prevención de hasta el 75 por ciento de las infecciones del sitio quirúrgico en cirugía de colon. Las evidencias científicas orientan hacia la necesidad del uso de profilaxis antibióticos orales más intravenosas asociados a la preparación mecánica del colon(AU)
ABSTRACT Surgical site infections are a concern with respect to quality of health care. Surgical site infections are potentially preventable through the application of evidence-based prevention guidelines. The aim is to describe the historical evolution of practicing prophylactic use of antibiotics in colon surgery since the last century. We analyzed the literature published in the last five decades in MEDLINE, Infomed and other secondary sources. The evolution is highlighted of the combined use of antimicrobials (aminoglycosides, penicillin, cephalosporins, and nitroimidazoles) associated with the vigorous preparation of the colon in the 1970s of the last century. Numerous antimicrobials and practices have been tested to demonstrate that the use of antibiotics to control aerobic and anaerobic bacteria, administered orally and intravenously, achieves the prevention of up to 75 percent of surgical site infections in colon surgery. Scientific evidence points to the need for the use of more intravenous oral antibiotic prophylaxis associated with mechanical preparation of the colon(AU)
Subject(s)
Humans , Quality of Health Care/trends , Surgical Wound Infection/prevention & control , Colon/surgery , Anti-Bacterial Agents/therapeutic use , Review Literature as TopicABSTRACT
Tradicionalmente se ha usado la preparación mecánica anorrectalen cirugía electiva para patologías comunes tales como: enferme-dad hemorroidal, fistula anorrectal y fisura anal. Objetivo: Evaluarel efecto de la preparación mecánica anorrectal. Métodos:Veinticuatro pacientes que tenían enfermedad hemorroidal, fisuraanal y fistula anorrectal, fueron intervenidos quirúrgicamente ydivididos aleatoriamente en dos grupos: grupo que no fue prepa-rado antes de la cirugía (N: 14) y grupo que fue preparado conenemas rectales (N: 10). Se estudio el dolor post operatorio, lacalidad del área operatoria y el reintegro a sus actividades habi-tuales. Resultados:no hubo diferencias estadísticamente signifi-cativas en las variables estudiadas en ambos grupos. Conclusión:El uso de la preparación mecánica anorrectal realizada antes de lacirugía anorrectal común, no proporciona beneficios intra o pos-toperatorios al paciente o al cirujano(AU)
Anorectal mechanical preparation has traditionally been used inelective surgery for common pathologies such as: hemorrhoidaldisease, fistula anorectal and anal fissure. Objective:To evaluatethe effect of anorectal mechanical preparation. Methods:Twenty-four patients who had disease hemorrhoid, anal fissure and ano-rectal fistula, were intervened surgically and divided randomizedinto two groups: group that was not prepared before surgery (N:14) and group which was prepared with rectal enemas (n: 10). Itwas study the pain post-op, the quality of the operative area andreturn to their usual activities. Results:There were no statisticallysignificant differences in the variables studied in both groups.Conclusion:The use of mechanical preparation done before thecommon anorectal surgery, anorectal does not provide benefitsintra or postoperative patient or the surgeon(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Pain, Postoperative , Rectal Diseases/surgery , Colonoscopy , Hemorrhoids , Anastomosis, Surgical , Mechanics , Gastrointestinal DiseasesABSTRACT
Objective: To compare and analyze the antimicrobial efficacy of three different mechanical preparation techniques in single infected root canals. Methods; Forty-five single root canals with chronic periapical periodontitis were selected. The specimens were divided into three groups randomly, 15 root canals per group. Croup A: preparation with stainless steel K-files (step-back technique), Croup B: preparation with HERO 642 NiTi rotary files (crown-down technique) and Group C: preparation with Mtwo NiTi rotary files ( modified crown-down technique). The sterile normal saline was used as irrigation. Samples were taken before and after canal preparation. The difference of CFU was calculated as well as the bacterial species. Results; All groups were effective to reduce bacteria within the infected root canals greatly(P<0.01). Croup A and Group C were statistically better than Group B(P<0.05). Group A was more effective than Group C but there was no statistically difference between them(P>0.05). Conclusion; Mechanical preparation can greatly reduce the intracanal bacteria, but can not obtain bacteria-free canals. The mechanical preparation must be aided by chemical irrigation to improve the success of root canal therapy.
ABSTRACT
The effectiveness of calcium hydroxide pastes: Calen and PMCC-Calen associated to chemo-mechanical preparation was assessed on Enterococcus faecalis grown within root canals. Seventy incisors were inserted into TSB medium, sterilized and contaminated with E. faecalis. Culture medium was replaced each 24 h and incubated at 37oC for 72 h. After chemo-mechanical preparation, root canals were filled with Calen or PMCC-Calen (7 or 14 days). Pastes were removed and teeth were inserted into test tubes containing Enterococcosel broth. Calen paste (maintained for 7 and 14 days) induced 70 percent elimination of enterococci and PMCC-Calen 100 percent elimination only after maintenance for 14 days. These medications were significantly more effective (p<0.001) than chemo-mechanical protocol alone and PMCC-Calen maintained for 7 days, both incapable to eliminate the viability of enterococci. Calcium hydroxide pastes demonstrated important adjuvant effects in the elimination of enterococci during chemo-mechanical preparation of root canal systems. When associated with PMCC, calcium hydroxide pastes should be maintained for at least 14 days.
A eficácia das pastas de hidróxido de cálcio: Calen® e Calen-PMCC® associadas ao preparo químico-mecânico, foi avaliada sobre Enterococcus faecalis cultivados no interior dos canais radiculares. Setenta incisivos foram inseridos em caldo TSB, esterilizados e contaminados com E. faecalis. O meio de cultivo foi substituído a cada 24 h, sendo incubados a 37oC por 72 h. Após o preparo químico-mecânico, os canais radiculares foram preenchidos com Calen® ou Calen-PMCC® (7 ou 14 dias). As pastas foram removidas e os dentes inseridos em tubos contendo caldo Enterococcosel. A pasta Calen® (mantida por 7 ou 14 dias) induziu a eliminação dos enterococos em 70 por cento dos dentes, enquanto a pasta Calen-PMCC® induziu a eliminação em 100 por cento dos dentes, somente após a manutenção por 14 dias. Tais medicações foram significativamente mais efetivas (p<0,001) do que o protocolo do preparo químico-mecânico e o Calen-PMCC® mantido por 7 dias, ambos incapazes de eliminar os enterococos. As pastas de hidróxido de cálcio demonstraram efeitos adjuvantes importantes na eliminação dos enterococos durante o preparo químico-mecânico dos sistemas de canais radiculares. Quando associada ao PMCC, as pastas de hidróxido de cálcio devem ser mantidas por pelo menos 14 dias.