Avaliação de três técnicas de limpeza do sítio cirúrgicoinfectado utilizando soro fisiológico
Evaluation of three techniques for cleaning infected surgical sitewith physiological serum
Evaluación de tres técnicas de limpieza del sitio quirúrgicoinfectado, utilizando suero fisiológico
Ciênc. cuid. saúde; 11 (supl), 2012
Publication year: 2012
Estudos internacionais adotam a técnica de limpeza de feridas por meio da irrigação sob pressão utilizando-seagulha 19 Gauges (G) e seringa de 35 mL que proporciona uma pressão conhecida de 4 a 8 psi, consideradosvalores ideais para limpeza. No Brasil, não há padronização deste material sendo necessárias adaptações.
Esteestudo tem como objetivo comparar três técnicas de limpeza de feridas com soro fisiológico:
por remoçãomecânica tradicional, irrigação com seringa de 20 mL com agulha 25x8 (21 G) e com agulha 40x12 (18G). Foramestudados três grupos de pacientes com feridas infectadas internados no Hospital Universitário de Londrina(HUL). Foram colhidas culturas por swab tanto antes como após a limpeza da lesão com soro fisiológico comuma das técnicas acima mencionadas. Os experimentos comprovaram que com a seringa de 20 mL e agulha18G a pressão do jato é de 9,5 psi e com agulha de 21G uma pressão de 12,5 psi. Embora as pressõesestejam dentro de faixa de valores considerados adequados pela literatura (4-15 psi), não houve reduçãobacteriana considerada estatisticamente significativa, porém percebeu-se maior frequência da reduçãobacteriana ao se utilizar agulha 21G.
International literature reports many studies on cleaning of wounds. In Brazil, this type of study is not common.From international studies, the irrigation wound cleaning technique with 19 Gauges (G) needle and 35 ml syringe,causing a pressure of 4 to 8 " psi", is considered to be ideal for the cleaning procedure. In Brazil, however, thereis no standardization of this material (35ml syringe and 19G needle) and adaptations are required.
This researchwas designed with the purpose to compare the reduction of microorganisms in infected wounds under thetreatment with saline solution and the application of three different techniques:
traditional mechanical removal,irrigation with 25 x 8 needles (21G) and 20 ml syringe, and irrigation with 40 x 12 (18G) needle and 20 ml syringe. Three groups of infected wounds in patients from the Regional University Hospital of Northern Paraná (HURNP)were studied, divided according to the cleaning technique to be applied in the lesion. It is worth mentioning thatthe first technique to be applied was chosen at random and the other two were interposed. Cultures werecollected from group I (mechanical removal) and group II (20ml syringe and 40 x 12mm needle) at first andsecondly from group III (20ml syringe and 25 x 18 needle). The cultures were collected by means of swabs beforeand after the cleaning with physiological serum and application of one of the techniques mentioned above. All thematerial collected was sent to the Laboratory of Microbiology of the HURNP, where a technique for quantitativemicrobiological analyses with swabs was developed in order to allow for the comparison of numbers of bacteriaboth before and after the cleaning procedure. A Faculty member from the Londrina State University Departmentof Physics collaborated in this study undertaking the experiments which could provide the pressure value the setof syringe and needle had on the sprays of saline solution during.
Estudios internacionales adoptan la técnica de limpieza de heridas por medio de la irrigación bajo presiónutilizándose aguja 19 Gauges (G) y jeringa de 35 ml, que proporciona una presión conocida de 4 a 8 psi,considerados valores ideales para limpieza. En Brasil, no hay estandarización de este material, siendo necesarioadaptaciones.
