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Complicated Surgical Wounds and Associated Factors in Oncology Patients
Carol Viviana Serna González1,2,3,4,5,6,7,8, Viviane Fernandes de Carvalho1,2,3,4,5,6,7,8, See Hee Park Kim1,2,3,4,5,6,7,8
1Carol Viviana Serna González, MSc, BSN, RN, ETN, is a PhD candidate at the Graduate Program in Adult Health Nursing at the School of Nursing of the University of Sao Paulo (Universidade de Sao Paulo, Escola de Enfermagem-EEUSP), Sao Paulo, Sao Paulo State, Brazil.
Abstract:
The objective of this study was to identify the occurrence of complicated surgical wounds (CSWs) and to analyze the associated factors in hospitalized patients at an oncology institution. This was an epidemiological, observational, cross-sectional, descriptive, and correlational study conducted in the intensive care and hospitalization units forming part of a large cancer hospital. Sociodemographic and clinical data were collected from medical records and physical examinations of the skin. Associations between the dependent variable (presence of CSWs) and the independent variables were obtained by chi-square tests and odds ratio (OR) calculations with a 95% confidence interval. Logistic regression (LASSO) was used to verify the possible predictors of the outcome. The sample consisted of 341 patients, specifically individuals who are White (46.9%), married (53.4%), and men (58.1%) with an average age of 59.2 years. Complicated surgical wounds were present in 3.2% of patients, and the most frequent types of complications were dehiscence (40%), infection (26.7%), and fistula (20%) present in the abdominal (40%), cephalic (26.7%), and cervical (13.3%) regions. Senile purpura, diaper use, and infection were the clinical variables associated with the occurrence of CSWs (p = .044, p = .001, and p < .001, respectively). Based on the logistic regression, the presence of infection (p < .001; OR = 90.8; 95% CI [18.42, 538.79]) persisted as a predictor of the occurrence of CSWs. From these observations, recommendations regarding best practices for the prevention of CSWs are made, specifically for patients with cancer.
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