Lesiones percutáneas durante procedimientos quirúrgicos
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J I Tokars1, D M Bell, D H Culver
1Hospital Infections Program, National Center for Infectious Diseases, Centers for Disease Control, Atlanta, Ga 30333.
JAMA
|June 3, 1992
Resumen
El personal quirúrgico sufre frecuentes lesiones percutáneas, principalmente por agujas de sutura, que representan riesgos de infección para ellos y los pacientes. Muchas lesiones se pueden prevenir a través de mejores dispositivos y técnicas quirúrgicas.
Área de la Ciencia:
- Infecciones asociadas al cuidado de la salud.
- Seguridad laboral en cirugía.
- Infecciones en el sitio quirúrgico infecciones en el sitio quirúrgico.
Sus antecedentes:
- Las lesiones percutáneas durante la cirugía presentan riesgos de transmisión de patógenos transmitidos por la sangre a los trabajadores de la salud y los pacientes.
- Comprender la incidencia y las circunstancias de estas lesiones es crucial para desarrollar estrategias efectivas de prevención.
Objetivo del estudio:
- Cuantificar la frecuencia e identificar las circunstancias de las lesiones percutáneas que ocurren en entornos quirúrgicos.
- Para evaluar el riesgo de exposición del paciente a la sangre del trabajador sanitario a través de instrumentos quirúrgicos contaminados.
Principales métodos:
- Diseño de estudio de observación que involucra el monitoreo directo de 1382 procedimientos quirúrgicos en cinco especialidades quirúrgicas en cuatro hospitales universitarios de los Estados Unidos.
- Recopilación de datos sobre lesiones percutáneas, incluido el tipo, el mecanismo y el personal involucrado, por observadores in situ.
- Análisis de regresión logística para determinar los factores asociados con el riesgo de lesiones.
Principales resultados:
- El 6,9% de los procedimientos resultaron en 99 lesiones percutáneas, principalmente de agujas de sutura (77%) que afectan a la mano no dominante.
- Se observó un mayor riesgo de lesión durante la histerectomía vaginal, mientras que se observó un menor riesgo en ciertos procedimientos ortopédicos.
- El uso de los dedos para el manejo de tejidos durante la sutura contribuyó al 35% de las lesiones; el 32% de las lesiones a los cirujanos involucraron el contacto de nuevo con la herida del paciente.
Conclusiones:
- Las lesiones percutáneas son comunes durante la cirugía, creando importantes riesgos laborales y de seguridad del paciente.
- Las medidas preventivas que se centran en la modificación del dispositivo, el refinamiento de la técnica y el equipo de protección son esenciales, pero requieren una evaluación rigurosa de la eficacia y el impacto en la atención al paciente.
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