em puérperas submetidas a cesarianas Surgical Risk Index and Surgical Site Infection in Postpartum Women Submitted to Cesarean Section

Justificativa e Objetivos: Tendo em vista que o emprego de vigilância ativa colabora na identificacao de infeccao e a necessidade de estudos que utilizem o Indice de Risco Cirurgico (IRC) para avaliacao de Infeccao de Ferida Cirurgica (IFC) em cesarianas este estudo objetiva determinar a incidencia de IFC e analisar a aplicabilidade do IRC na predicao das IFC em puerperas submetidas a cesariana em hospital universitario entre abril de 2012 e marco de 2013. Metodos: Estudo de coorte prospectivo concorrente. Informacoes de notificacao das IFC por vigilância ativa foram coletadas diariamente nos prontuarios. Apos alta hospitalar, as puerperas eram contatadas por ligacoes telefonicas para identificacao de criterios de infeccao ate 30 dias apos a cesariana. Analises descritivas e comparativas foram conduzidas. Para comparacao dos grupos foi utilizado teste de Qui-quadrado. Resultados: Foram realizadas 737 cesarianas. Contato telefonico foi conseguido com 507 (68,8%) puerperas ate 30 dias pos-parto, com perda de seguimento de 230 casos (31,2%). A consulta medica no puerperio ocorreu em 188 (37,08%) mulheres com quem foi obtido contato telefonico, em media, 17,28 dias (± 8,39) apos o parto. Verificou-se que 21 casos preencheram criterios para IFC, taxa de 4,14%. Classificou-se 12 (57,1%) casos como infeccao de ferida cirurgica superficial, 5 (23,8%) como profunda e 4 (19,1%) de orgaos e cavidades. O IRC e suas variaveis de risco nao foram associados a IFC em pacientes submetidas a cesarianas. Conclusao: O IRC e as variaveis de risco incluidas nesse indice nao foram associados a IFC em pacientes submetidas a cesarianas. Backgound and Objectives: Considering the use of active surveillance assists in infection identification and the need for studies that use Surgical Risk Index (SRI) for assessment of Surgical Site Infection (SSI) in cesareans, this study aims to determine the incidence of SSI and analyze the applicability of SRI in the prediction of SSI in women in the postpartum period after being submitted to a cesarean section at a university hospital between April 2012 and March of 2013. Methods: Prospective cohort study. Information notifying SSI by active surveillance was collected daily from the medical records. After hospital discharge, the mothers were contacted through telephone calls to identify infection criteria within 30 days after the cesarean. Descriptive and comparative analyses were performed. The chi-square test was used to compare groups. Results: 737 cesareans were performed. Telephone contact was achieved with 507 (68.8%) women up to 30 days postpartum, with loss of follow-up of 230 cases (31.2%). The medical consultation in the post-partum period occurred with 188 (37.08%) women, with whom telephone contact was obtained, on average, 17.28 days (SD=8.39) after delivery. It was verified that 21 patients met the criteria for SSI, with a 4.14% rate. A total of 12 cases (57.1%) were classified as superficial SSI, 5 (23.8%) as deep and 4 (19.1%) as infection of organs and cavities. The SRI and its risk variables were not associated with SSI in patients submitted to cesarean sections. Conclusion: The SRI and the risk variables included in this index were not associated to SSI in patients submitted to cesarean sections. RESUMO