RESUMO
Introducción: La infección de la herida quirúrgica en apendicitis aguda complicada es frecuente. Objetivo: El objetivo fue comparar la solución Dakin y la Superoxidativa para prevenir infecciones de herida quirúrgica en pacientes con apendicitis aguda complicada. Métodos: Estudio comparativo, transversal, en 104 pacientes con apendicitis aguda complicada (Edad media: 36.29 años, 69(66.43%) hombres). Grupo-1: 52 pacientes, con lavado de herida quirúrgica con solución Dakin modificada. Grupo-2: 52 pacientes con solución superoxidativa (Microdacyn®). Se administró ceftriaxona 1 gr antes de la cirugía, se realizó apendicectomía convencional y cierre de pared con Vicryl-1 y Nylon-2/0. Se evaluó herida quirúrgica 7 días después de la operación, registrando presencia de pus, edema, eritema y calor local. Se utilizaron X2 y t de Student. Resultados: Se presentó infección de herida quirúrgica en 11(10.6%) pacientes; 3(5.8%) pacientes del Grupo-1 y 8(15.4%) del Grupo-2 (p=0.1). Conclusión: Ambas soluciones son útiles para prevenir infecciones de herida quirúrgica en pacientes con apendicitis aguda complicada.
Introduction: The infection of the surgical wound in a complicated acute appendicitis is common. Objective: The objective was to compare Dakin and Superoxidative solutions in preventing surgical wound infections in patients with complicated acute appendicitis. Methods: Comparative, cross-sectional study of 104 patients with complicated acute appendicitis (Average age: 36.29 years, 69 (66.43%) men). Group-1: 52 patients, with surgical wound wash using modified Dakin's solution. Group-2: 52 patients with superoxidative solution (Microdacyn®). Ceftriaxone 1 gr was administered before surgery, conventional appendectomy was performed, and the wall was closed with Vicryl-1 and Nylon-2/0. The surgical wound was evaluated 7 days after the operation, noting the presence of pus, edema, erythema, and local heat. Chi-squared (X2) and Student's t-tests were used. Results: Surgical wound infection occurred in 11 (10.6%) patients; 3 (5.8%) patients from Group-1 and 8 (15.4%) from Group-2 (p=0.1). Conclusion: Both solutions are useful in preventing surgical wound infections in patients with complicated acute appendicitis.
RESUMO
Due to the growing number of outbreaks of infection in hospital and nurseries, it becomes essential to set up a sanitation program that indicates that the appropriate chemical agent was chosen for application in the most effective way. Validating the effectiveness of decontamination and disinfection is an important and often challenging task. In order to study and compare the behavior of selected microorganisms, they were submitted to minimal inhibitory concentration (MIC). The MIC intervals, which reduced bacteria populations over 6 log10, were: 59 to 156 mg/L of quaternary ammonium compounds (QACs); 63 to 10000 mg/L of chlorhexidine; 1375 to 3250 mg/L of glutaraldehyde; 39 to 246 mg/L of formaldehyde; 43750 to 87500 mg/L of ethanol; 1250 to 6250 mg/L of iodine in polyvinyl-pyrolidone complexes, 150 to 4491 mg/L of chlorine-releasing-agents (CRAs) and 469 to 2500 mg/L of hydrogen peroxide. Chlorhexidine showed non inhibitory activity over germinating spores. A. calcoaceticus showed resistance to the majority of the agents tested, followed by E. cloacae and S. marcescens.
Devido ao número crescente de surtos de infecção hospitalar, torna-se proeminente o estabelecimento de um programa de sanitização que liste os agentes químicos a serem empregados e o modo de aplicação mais efetivo. Validação da eficácia de descontaminação é uma tarefa ao mesmo tempo importante e desafiadora. Para estudar e comparar o comportamento dos microrganismos selecionados foram realizados ensaios de concentração inibitória mínima (CIM). A CIM capaz de reduzir o bioburden inicial (>6 log10) foi: 59 - 156 mg/L de quartenários de amônia; 63 - 10000 mg/L de clorexidina, 1375 - 3250 mg/mL de glutaraldeído, 39 - 246 mg/L de formaldeído, 43750 - 87500 mg/L de etanol 1250 - 6250 mg/L de PVPI, 150 - 4491 mg/L de compostos liberadores de cloro e 469 -2500 mg/L de peróxido de hidrogênio.