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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(01): 045-052
DOI: 10.1016/j.rbo.2017.09.008
Original Article | Artigo Original
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Contaminação de enxertos de tendões flexores na reconstrução do ligamento cruzado anterior: comparação de duas técnicas de retirada[*]

Article in several languages: português | English
Eduardo Frois Temponi 
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Luís Henrique Grassi Marques da Costa
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Luiz Fernando Machado Soares
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
,
Lúcio Honório de Carvalho Júnior
1   Hospital Madre Teresa, Belo Horizonte, MG, Brasil
2   Faculdade de Medicina, Departamento do Aparelho Locomotor, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
3   Departamento de Medicina, Pontifícia Universidade Católica, Belo Horizonte, MG, Brasil
› Author Affiliations
Further Information

Publication History

01 July 2017

05 September 2017

Publication Date:
01 March 2019 (online)

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Resumo

Objetivo

Avaliar a taxa de contaminação de autoenxerto de tendões flexores comparando duas técnicas e verificar se a contaminação intraoperatória está associada ao desenvolvimento de infecção clínica em pacientes submetidos a reconstrução do ligamento cruzado anterior.

Métodos

Foram feitas 110 reconstruções do ligamento cruzado anterior com tendão dos flexores e divididas em dois grupos: 1) técnica com retirada total dos tendões flexores e 2) técnica que manteve a inserção tibial desses tendões. Durante o preparo, dois fragmentos de cada um desses foram enviados para cultura, sendo mensurado o tempo de retirada dos tendões, do preparo dos tendões e total da cirurgia. Com 24 horas de pós-operatório, foi dosada a proteína C reativa. Seguimento clínico ambulatorial foi realizado de forma protocolada até 180 dias de pós-operatório.

Resultados

Apesar de terem sido observadas duas infecções pós-operatórias, não houve contaminação dos enxertos nem diferença entre os grupos em relação ao tempo de preparo dos enxertos e a proteína C reativa com 24 horas de pós-operatório. A técnica clássica apresentou maior tempo de retirada do enxerto (p = 0,038) e não houve diferença estatística entre os dois grupos no que tange ao grau de contaminação e consequente infecção clínica, embora dois pacientes do grupo 2 tenham tido infecção com culturas perioperatórias negativas.

Conclusão

Com base nos resultados obtidos, não houve associação entre contaminação do enxerto com o tempo ou a técnica de sua preparação, tampouco entre a contaminação intraoperatória e o desenvolvimento de infecção clínica ou entre alteração precoce da proteína C reativa e o surgimento de infecção.

Palavras-chave

enxerto de flexores - reconstrução do ligamento cruzado anterior - infecção - artrite séptica

* Trabalho desenvolvido no Hospital Madre Teresa, Belo Horizonte, MG, Brasil. Publicado originalmente por Elsevier Editora Ltda. © 2018 Sociedade Brasileira de Ortopedia e Traumatologia.


 

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