Medidas y contribuciones de la literatura para la prevención de infecciones del sitio quirúrgico: revisión del alcance
DOI:
https://doi.org/10.17058/reci.v16i.20612Palabras clave:
Infección de La Herida Quirúrgica, Control de Infecciones, Asistencia PerioperatoriaResumen
Justificación y Objetivos: A pesar de los avances en las técnicas quirúrgicas y las medidas preventivas, la infección del sitio quirúrgico sigue siendo frecuente, lo que repercute en la recuperación del paciente y genera costes sustanciales. Por lo tanto, es importante desarrollar un estudio que permita identificar las lagunas de conocimiento más significativas. Esto se justifica por la elevada morbilidad y mortalidad asociadas a las infecciones postoperatorias, presentes en la literatura, que representan un reto para los sistemas hospitalarios. Su objetivo es identificar en la literatura las medidas más eficaces y las áreas en las que la producción científica aún es insuficiente, contribuyendo a mejorar los protocolos y las políticas institucionales. Contenidos: Revisión de alcance realizada con las bases de datos MEDLINE, Web of Science, SCOPUS, SciELO y CINAHL, llevada a cabo de acuerdo con la metodología impuesta por el Joanna Briggs Institute para revisiones de alcance y guiada por la lista de verificación Preferred Reporting Items for Systematic reviews and Meta-analyses Scoping Review en diez etapas. Los datos se analizaron en un proceso doble ciego, teniendo en cuenta los criterios de inclusión como estudios observacionales, tanto transversales como longitudinales y primarios, además de revisiones sistemáticas, disponibles en su totalidad. Conclusiones: Las estrategias basadas en la evidencia, combinadas con tecnología avanzada y enfoques multidisciplinarios, han demostrado reducir significativamente las tasas de mortalidad, la duración de la hospitalización y el impacto de las complicaciones a largo plazo. Además, los artículos de la muestra final destacaron importantes lagunas que deben estudiarse durante un período de tiempo más largo, centrándose en estudios en países subdesarrollados, en el seguimiento posterior al alta para detectar infecciones tardías y en la medición del cumplimiento de los protocolos institucionales por parte del personal.
Descargas
Referencias
1. Brasil. Ministério da Saúde (BR). Agência Nacional de Vigilância Sanitária. Orientações para a notificação dos indicadores nacionais das infecções relacionadas à assistência à saúde e resistência aos antimicrobianos [Internet]. Brasília (DF): Agência Nacional de Vigilância Sanitária; 2025. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/notas-tecnicas/notas-tecnicas-vigentes/nota-tecnica-gvims-ggtes-dire3-anvisa-no-02-2025.
2. World Health Organization (WHO). Global Guidelines for the Prevention of Surgical Site Infection [Internet]. 2ª ed. Geneva: WHO; 2018. Available from: https://wkc.who.int/resources/publications/i/item/global-guidelines-for-the-prevention-of-surgical-site-infection-2nd-ed?utm_source.
3. Berríos-Torres SI, Umscheid CA, Bratzler DW et al. Centers for Disease Control and Prevention Guideline for the Prevention of Surgical Site Infection, 2017. JAMA Surg. 2017;152(8):784–791. doi: https://doi.org/10.1001/jamasurg.2017.0904.
4. National Institute for Health and Care Excellence (NICE). Surgical site infections: prevention and treatment. NICE guideline NG125. London: NICE; 11 April 2019. Available from: https://www.nice.org.uk/guidance/NG125?utm_source.
5. Santos EV, Souza MJ, Lima AP et al. Infecções de feridas pós-cesáreas e os cuidados de enfermagem: uma revisão da literatura. Rev Ibero-Am Humanid Ciênc Educ. 2023;9(11):3764-73. doi: https://doi.org/10.36489/nursing.2022v25i290p8207-8220.
6. Brasil. Ministério da Saúde (BR). Agência Nacional de Vigilância Sanitária. Programa Nacional de Prevenção e Controle de Infecções Relacionadas à Assistência à Saúde (PNPCIRAS) 2021-2025 [Internet]. Brasília: ANVISA; 2021. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/pnpciras_2021_2025.pdf.
7. United Nations. Transforming our world: the 2030 Agenda for Sustainable Development [Internet]. New York: UN; 2015. Available from: https://sdgs.un.org/2030agenda.
8. Aromataris E, Lockwood C, Porritt K et al. editors. JBI Manual for Evidence Synthesis. JBI; 2024. Available from: https://jbi-global-wiki.refined.site/space/MANUAL.
9. Page MJ, McKenzie JE, Bossuyt PM et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews BMJ 2021; 372. n71 doi: https://doi.org/10.1136/bmj.n71.
10. Brasil. Ministério da Saúde (BR). Agência Nacional de Vigilância Sanitária. Medidas de prevenção de infecção relacionada à assistência à saúde [Internet]. 2017. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/caderno-4-medidas-de-prevencao-de-infeccao-relacionada-a-assistencia-a-saude.pdf/view.
11. Greif R, Akça O, Horn EP et al. Outcomes Research Group. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection. N Engl J Med. 2000;342(3):161-7. doi: https://www.nejm.org/doi/full/10.1056/NEJM200001203420303.
12. Antoniali F, Costa CE, Tarelho LS et al. The impact of new preventive measures and treatment of surgical site infections after coronary artery bypass graft surgery. Braz J Cardiovasc Surg. 2005;20(4):382-91. doi: https://doi.org/10.1590/S0102-76382005000400006.
13. Gilson D. Prevention of surgical site infections: "Save 100,000 Lives Campaign". Wyoming Nurse. 2006;6:6. doi: https://doi.org/10.1016/S1553-7250(06)32080-6.
14. Cunha ER, Matos FGOA, Silva A et al. The efficacy of three hand asepsis techniques using chlorhexidine gluconate (GCH 2%). Rev Esc Enferm USP. 2011;45(6):1440-5. doi: https://doi.org/10.1590/s0080-62342011000600023.
15. Orth K. Preventing surgical site infections related to abdominal drains in the intensive care unit. Crit Care Nurse. 2018;38(4):20-6. Doi: https://doi.org/10.4037/ccn2018254.
16. Prates CG, Stadñik CMB, Bagatini A et al. Comparison of surgical infection rates after implementation of a safety checklist. Acta Paul Enferm. 2018;31(2):116-22. doi: https://doi.org/10.1590/1982-0194201800018.
17. Qvistgaard M, Lovebo J, Almerud-Österberg S. Intraoperative prevention of surgical site infections as experienced by operating room nurses. Int J Qual Stud Health Well-being. 2019;14(1):1632109. doi: https://doi.org/10.1080/17482631.2019.1632109.
18. Edmiston CE Jr, Lavin P, Spencer M et al. Antiseptic efficacy of an innovative perioperative surgical skin preparation: a confirmatory FDA phase 3 analysis. Infect Control Hosp Epidemiol. 2020;41(6):653-9. doi: https://doi.org/10.1017/ice.2020.27.
19. National Institute for Health Research Global Research Health Unit on Global Surgery. Delphi prioritization and development of global surgery guidelines for the prevention of surgical‑site infection. Br J Surg. 2020;107(8):970-7. doi: https://doi.org/10.1002/bjs.11530.
20. Castellà L, Sopena N, Rodriguez-Montserrat D et al. Intervention to reduce the incidence of surgical site infection in spine surgery. Am J Infect Control. 2020;48(5):550-4. doi: https://doi.org/10.1016/j.ajic.2019.09.007.
21. Jonge SW, Wolfhagen N, Zwinderman AH et al. Enhanced perioperative care and health protection programme for the prevention of surgical site infections after elective abdominal surgery (EPO2CH): statistical analysis plan of a randomised controlled multicentre superiority trial. Trials. 2021;22(1):297. doi: https://doi.org/10.1186/s13063-021-05202-y.
22. Arezzo A, Mistrangelo M, Bonino MA et al. Oral neomycin and bacitracin are effective in preventing surgical site infections in elective colorectal surgery: a multicentre, randomized, parallel, single-blinded trial (COLORAL-1). Updates Surg. 2021;73:1775-86. doi: https://doi.org/10.1007/s13304-021-01112-5.
23. Ohge H, Mayumi T, Haji S et al. The Japan Society for Surgical Infection: guidelines for the prevention, detection, and management of gastroenterological surgical site infection, 2018. Surg Today. 2021;51:1-31. doi: https://doi.org/10.1007/s00595-020-02181-6.
24. Clayphan B, Dixon L, Biggs S et al. PreciSSIon Collaborators. PreciSSIon: a collaborative initiative to reduce surgical infections after elective colorectal surgery. J Hosp Infect. 2022;130:131-7. doi: https://doi.org/10.1016/j.jhin.2022.08.012.
25. Araújo BS, Oliveira AC. Compliance with surgical site infection prevention measures in hospitals. Acta Paul Enferm. 2023;36:eAPE01714. doi: https://doi.org/10.37689/acta-ape/2023AO017134.
26. Eder M, Sommerstein R, Szelecsenyi A et al. Association between the introduction of a national targeted intervention program and the incidence of surgical site infections in Swiss acute care hospitals. Antimicrob Resist Infect Control. 2023;12(1):134. doi: https://doi.org/10.1186/s13756-023-01336-7.
27. Chien Y, Lin J, Yeh C et al. Effect of standardized bundle care and bundle compliance on reducing surgical site infections: a pragmatic retrospective cohort study. Med Sci Monit. 2024;30:e943493-1. doi: https://doi.org/10.12659/msm.943493.
28. Crisafi C, Grant MC, Rea A et al. Enhanced recovery after surgery cardiac society turnkey order set for surgical-site infection prevention: Proceedings from the American Association for Thoracic Surgery ERAS Conclave 2023. J Thorac Cardiovasc Surg. 2024;168(5):1500-9. doi: https://doi.org/10.1016/j.jtcvs.2024.03.027.
29. Brasil. Ministério da Saúde (BR). Agência Nacional de Vigilância Sanitária. Higiene das mãos. [Internet]. 2024. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/manuais/cadernos-de-seguranca-do-paciente-e-qualidade-em-servicos-de-saude-2024-versoes-preliminares-nao-finalizadas-aguardando-o-envio-de-sugestoes/caderno-12-higiene-das-maos-nov-2024-assistencia-segura-nov-2024-versao-preliminar-nao-finalizada-aguardando-o-envio-de-sugestoes/view.
30. Pop-Vicas A, Safdar N. Preoperative decolonization as a strategy to reduce surgical site infection. Curr Infect Dis Rep. 2019;21:35. doi: https://doi.org/10.1007/s11908-019-0692-7.
31. Agodi A. Principles of infection prevention and control in surgery. In: Bartoli S, Cortese F, Sartelli M, Sganga G, editors. Infections in Surgery. Cham: Springer; 2025. p. 37-46. doi: https://doi.org/10.1007/978-3-031-60462-1_5.
32. Oliveira MC, Dalcól C, Carvalho REFL et al. Patient participation in surgical site infection prevention: perceptions of nurses, physicians and patients. Rev Esc Enferm USP. 2023;57:e20220459. doi: https://doi.org/10.1590/1980-220X-REEUSP-2022-0459en.
33. Wolfhagen N, Boldingh QJJ, Boermeester MA et al. Perioperative care bundles for the prevention of surgical-site infections: meta-analysis. Br J Surg. 2022;109(10):933-42. doi: https://doi.org/10.1093/bjs/znac196.
34. Seidelman JL, Mantyh CR, Anderson DJ. Surgical site infection prevention: a review. JAMA. 2023;329(3):244-52. doi: https://doi.org/10.1001/jama.2022.24075.
35. Sara CC, Andrew JJ, Galen P, Peter N. Surgical care bundles for surgical site infection prevention in high-income and low-to-middle-income countries: A comparative review, Perioperative Care and Operating Room Management. 2024;35-100406, ISSN 2405-6030. Doi: https://doi.org/10.1016/j.pcorm.
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2026 Callado Silva Moura, Andressa Maria de Sousa Moura, Ana Carolina de Macêdo Lima, Olga Maria Castro de Sousa, Sannya Paes Landim Brito Alves, Luana Bastos Araújo, Odinéa Maria Amorim Batista

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
The author must state that the paper is original (has not been published previously), not infringing any copyright or other ownership right involving third parties. Once the paper is submitted, the Journal reserves the right to make normative changes, such as spelling and grammar, in order to maintain the language standard, but respecting the author’s style. The published papers become ownership of RECI, considering that all the opinions expressed by the authors are their responsibility. Because we are an open access journal, we allow free use of articles in educational and scientific applications provided the source is cited under the Creative Commons CC-BY license.