Protetor de ferida operatória de baixo custo para cirurgias laparoscópicas
Low-cost wound protector for laparoscopic surgeries
Carlos Augusto Metidieri Menegozzo; Cristiane Prestes da Rosa Oliveira; Roberto Rasslan; Felipe Kfouri; Alberto Bitran; Renato Silveira Leal; Sergio Henrique Bastos Damous; Edivaldo Massazo Utiyama
Resumo
O papel dos protetores de ferida operatória em cirurgias laparoscópicas é bastante controverso na literatura. Alguns estudos demonstram seu benefício na redução da taxa de infeções de sítio cirúrgico, porém esses resultados não são reprodutíveis em todos os procedimentos. Além da proteção da ferida operatória, esses dispositivos podem ser utilizados nos sítios de extração de peças cirúrgicas em procedimentos laparoscópicos. Há vários dispositivos comercialmente disponíveis para esse fim, entretanto são pouco disponíveis nos serviços com menos recursos. Um dos motivos dessa limitação é o custo do dispositivo. Nesta nota, buscamos oferecer uma opção barata que utiliza materiais amplamente disponíveis no centro cirúrgico e cuja confecção é simples.
Palavras-chave
Abstract
The role of wound protectors in laparoscopic surgeries is highly controversial in the literature. Some studies demonstrate their benefit in reducing the rate of surgical site infections; however, these results are not reproducible across all procedures. In addition to protecting the operative wound, these devices can be used at sites of surgical specimen extraction in laparoscopic procedures. Several commercially available devices serve this purpose but are scarcely available in resource-limited settings. One of the reasons for this limitation is the cost of the device. In this technical note, we aim to provide a cost-effective option utilizing materials readily available in the operating room and with a simple fabrication process.
Keywords
Referências
1 CDC. Surgical Site Infection Event (SSI). Natl Healthc Saf Netw. 2023:1-39. (
2 Anderson DJ, Podgorny K, Berríos-Torres SI, Bratzler DW, Dellinger EP, Greene L, et al. Strategies to Prevent Surgical Site Infections in Acute Care Hospitals: 2014 Update. Infect Control Hosp Epidemiol. 2014;35(6):605-27. DOI: 10.1086/676022
3 Ban KA, Minei JP, Laronga C, Harbrecht BG, Jensen EH, Fry DE, et al. American College of Surgeons and Surgical Infection Society: Surgical Site Infection Guidelines, 2016 Update. J Am Coll Surg. 2017;224(1):59-74. DOI: 10.1016/j.jamcollsurg.2016.10.029
4 Li X, Lin H, Zhu L, Chen J, Lei S, Li B, et al. The clinical effectiveness of wound edge protectors in reducing surgical site infection after abdominal surgery: Meta-analysis. BJS Open. 2022;6(3). DOI: 10.1093/bjsopen/zrac065
5 Chen C-F, Tsai H-L, Huang C-W, Yeh Y-S, Ma C-J, Chang T-K, et al. Impact of a Dual-Ring Wound Protector on Outcome After Elective Surgery for Colorectal Cancer. J Surg Res. 2019;244:136-45. DOI: 10.1016/j.jss.2019.06.014
6 Kercher KW, Nguyen TH, Harold KL, Poplin ME, Matthews BD, Sing RF, et al. Plastic wound protectors do not affect wound infection rates following laparoscopic-assisted colectomy. Surg Endosc Other Interv Tech. 2004;18(1):148-51. DOI: 10.1007/s00464-003-8137-6
7 Hassan K, Baloch S, Tan EJZ, Chamberlain J, Ashfaq A, Shah J, et al. The effect of intraoperative wound protector use on the risk of surgical site infections in patients undergoing pancreatoduodenectomy: a systematic review and meta-analysis. Langenbeck's Arch Surg. 2022;407(2):459-68. DOI: 10.1007/s00423-021-02420-5
8 Ortega G, Rhee DS, Papandria DJ, Yang J, Ibrahim AM, Shore AD, et al. An evaluation of surgical site infections by wound classification system using the ACS-NSQIP. J Surg Res. 2012;174(1):33-8. DOI: 10.1016/j.jss.2011.05.056
9 Cohen NS, Bock JM, May AK. Sepsis and postoperative surgical site infections. Surg (United States). 2023;174(2):403-5. DOI: 10.1016/j.surg.2023.01.006
10 Alkaaki A, Al-Radi OO, Khoja A, Alnawawi A, Alnawawi A, Maghrabi A, et al. Surgical site infection following abdominal surgery: A prospective cohort study. Can J Surg. 2019;62(2):111-7. DOI: 10.1503/cjs.004818
11 Mihaljevic AL, Müller TC, Kehl V, Friess H, Kleeff J. Wound Edge Protectors in Open Abdominal Surgery to Reduce Surgical Site Infections : A Systematic Review and Meta-Analysis. 2015;1-24. DOI: 10.1371/journal.pone.0121187
12 Ahmed K, Connelly TM, Bashar K, Walsh SR. Are wound ring protectors effective in reducing surgical site infection post appendectomy? A systematic review and meta-analysis. Ir J Med Sci. 2016;185(1):35-42. DOI: 10.1007/s11845-015-1381-7
13 da Silva JJ, Silva RM el., Costa KK. Nova alternativa para proteção da ferida cirúrgica em colectomia laparoscópica. Arq Bras Cir Dig. 2015;28(1):61-7. DOI: 10.1590/S0102-67202015000100016
Submetido em:
02/04/2024
Aceito em:
05/05/2024
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