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CC BY-NC-ND 4.0 · Rev Bras Ortop (Sao Paulo) 2019; 54(06): 617-626
DOI: 10.1016/j.rbo.2017.12.003
Artigo de Revisão
Sociedade Brasileira de Ortopedia e Traumatologia. Published by Thieme Revnter Publicações Ltda Rio de Janeiro, Brazil

Profilaxia infecciosa com aplicação local de vancomicina em pó em cirurgias ortopédicas: Revisão sistemática com metanálise[*]

Artikel in mehreren Sprachen: português | English
David Sadigursky 
1   Clínica Ortopédica Traumatológica, Centro de Estudos em Ortopedia e Traumatologia (COT-CEOT), Salvador, BA, Brasil
,
Mariana Drummond Sousa
1   Clínica Ortopédica Traumatológica, Centro de Estudos em Ortopedia e Traumatologia (COT-CEOT), Salvador, BA, Brasil
,
Yasmin Galvão Linhares Cajaíba
2   Faculdade de Tecnologia e Ciências (FTC), Salvador, BA, Brasil
,
Rodrigo Rêgo Martins
1   Clínica Ortopédica Traumatológica, Centro de Estudos em Ortopedia e Traumatologia (COT-CEOT), Salvador, BA, Brasil
,
Diogo Maciel Vieira Lobão
2   Faculdade de Tecnologia e Ciências (FTC), Salvador, BA, Brasil
› Institutsangaben
Weitere Informationen

Publikationsverlauf

22. September 2017

07. Dezember 2017

Publikationsdatum:
23. September 2019 (online)

   Lizenzen und Reprints

Resumo

Apesar das diversas estratégias perioperatórias empregadas para diminuir a incidência de infecção no sítio cirúrgico (ISS), tais complicações ainda são frequentes, e representam um desafio para os ortopedistas. Por esse motivo, há uma necessidade permanente de buscar métodos cada vez mais eficazes de profilaxia anti-infecciosa, para que sejam reduzidas significativamente as taxas de morbidade pós-operatória, mortalidade, e os custos com os cuidados de saúde. Este estudo teve como objetivo avaliar a eficácia da profilaxia infecciosa com aplicação tópica de vancomicina em pó em cirurgias ortopédicas.

Fez-se um estudo de revisão sistemática com metanálise, usando-se o Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols 2015 (PRISMA-P 2015). Fez-se uma busca abrangente na literatura por estudos controlados sobre as taxas de ISS com e sem o uso de vancomicina em pó na ferida.

Entre os 412 títulos encontrados que preencheram os critérios, foram selecionados 7 estudos, 4 prospectivos e 3 retrospectivos, todos em cirurgia de coluna. A amostra total foi de 6.944 pacientes, que foram divididos em 2 grupos: controle (3.814 pacientes) e intervenção (3.130 pacientes). Observou-se que no grupo intervenção, no qual a vancomicina tópica foi aplicada, 64 (2,04%) pacientes desenvolveram ISS, e, no grupo controle 144 (3,75%) pacientes. Os resultados da metanálise demonstraram que o uso de vancomicina tem efeito protetor contra ISS em cirurgias de coluna, com risco relativo (RR) de 0,59, significância estatística, e intervalo de confiança de 95% (IC95%) entre 0,35–0,98.

O uso da vancomicina em pó profilática, no leito da ferida, tem fator protetor contra ISS em cirurgias de coluna; entretanto, mais ensaios prospectivos randomizados são necessários para recomendar seu uso em cirurgias ortopédicas.

Palavras-chave

vancomicina - infecção da ferida cirúrgica - ortopedia

* Trabalho desenvolvido na Clínica Ortopédica Traumatológica, Centro de Estudos em Ortopedia e Traumatologia (COT-CEOT), Salvador, BA, Brasil. Publicado Originalmente por Elsevier Editora Ltda.


 

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