Infection of the Surgical Site: Incidence in Patients Submitted to Hernia Surgery

Tuesday, 14 July 2009

Teresa Akiko Carbone Paula, RN
Section of Control of Hospitalar Infection, Faculty of Nursing of Santa Casa Medical School, São Paulo, Brazil
Maria Aparecida Neves, RN
Graduation, Faculty of Nursing of Santa Casa Medical School, São Paulo, Brazil
Ivone Regina Fernandes, PhD, RN
Nursing, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
Maria do Carmo Querido Avelar, RN, PhD
Post Graduation Course in Nursing, University Guarulhos, Guarulhos, Brazil

Learning Objective 1: consider the need of discussing, between professionals, about the results of the educative action by the epidemiological vigilance nurse, on the Nosocomial Institution.

Learning Objective 2: analyse critically the results obtained, focusing on the epidemiological vigilance.

Purpose: It is known that 24% of the nosocomial infections result from the Infections of the Surgical Site (ISS) and that 20% of these can be prevented by the implementation of epidemiological vigilance measures, taking heed, nevertheless, of the patient in the process of the infection generation. To determine the incidence of  ISS in patients submitted to hernia surgery  after the discharge from the hospital.

Methods: This is a descriptive, prospective, quantitative field study, developed on the surgical ambulatory of a philanthropic school hospital, in the city of São Paulo. It includes 4308 (100%) adult patients, of both sexes, submitted hernia surgery and with ambulatorial return in a period up to 30 days from the hospital discharge. We used a mixed search (active and passive) to detect the ISS cases, during a period of 6 years.

Results: Of the 4308 (100%) patients that returned to the surgical ambulatory, 230 (5,33%) presented ISS. Of these, 137 (59,56%) were inpatients and 93 (40,43%) were ambulatorial patients. The patients were classified  according to the topography of their hernias: inguinal (97 – 42,17%); umbilical (60 – 26,08%); incisory (48 – 20,86%) and others ( 25 –10,86%). The ISS index for the five surgical teams ranged from 4,33% to 9,16%. The annual incidence, observed over a 6 years period, had the following distribution: first year –  8,94%; 2 – 9,86%; 3 – 5,98%; 4 – 4,38%; 5 – 2,06%;  and, in the last year, 1,25%.

Conclusion: The incidence of ISS in patients submitted to hernia surgery, detected by the epidemiologic vigilance, was 230 (5,33%) of the patients during the period of 6 years. Considering the work developed by the Nosocomial Infection Control Service we can see a reduction of incidence from 8,37%  (first year) to 1,25%  ( last year).