[Presurgical preparation and surgical site infection in neck surgery. The effect of the protocol adequacy in the improvement of the health care quality]. / Impacto de la adecuación del protocolo de preparación prequirúrgica en la incidencia de infección de localización quirúrgica en cirugía cervical.

BACKGROUND: Surgical wound infection is one of the leading causes of healthcare-associated infections. One of the most common measures for its reduction is the pre-surgical preparation. The aim of this study was to evaluate the adequacy to the pre-surgical protocol in patients undergoing neck surgery and the relationship with the incidence of surgical wound infection. MATERIAL AND METHODS: Observational cohort study, conducted from January 2011 to December 2017. Variables related to patient, pre-surgical preparation and infection were collected. Infection rate was calculated after a maximum period of 30days after surgery. The effect of the pre-surgical preparation's adequacy and infection was evaluated. RESULTS: The study included 131 patients. The global adequacy of the pre-surgical protocol was 84.7%, being the main cause of inadequacy the application of the mouthwash (7.6% of the interventions). The overall incidence of surgical wound infection during the follow-up period was 4.6% (95%CI: 1.0%-8.2%). No relationship between the adequacy to the protocol and the presence of infection was found (P=.59). CONCLUSIONS: Adequacy of the pre-surgical preparation in our hospital was high and the incidence of surgical wound infection was low, and no relationship was found between the two. The results show a high safety culture in this surgery. However, there is still room for improvement in the quality of care of our patients.

[Laryngotracheal NK/T lymphoma: clinical case]. / Linfoma T/NK laringotraqueal: caso clínico.

NK/T-cell lymphoma is a rare condition with an aggressive course and poor prognosis. Historically known as «lethal midline granuloma¼, it generally appears in a midfacial location. We describe the case of a 22-year-old Colombian woman with laryngotracheal affectation, presenting with hoarseness and hemoptysis. CT scan and MRI showed severe laryngeal and tracheal destruction. The biopsy showed a polymorphic, lymphoid cell infiltrate with angiocentric and angiodestructive pattern. The immunohistochemical study confirmed the immunophenotype of the NK/T-cells: CD2+, CD56+ and cytoplasmic CD3+. The in situ hybridization and flow cytometry findings were: EBER+, TIA-1+ and perforin+. The patient died from complications of her disease, before undergoing oncologic treatment.