Abstract
ABSTRACTObjective:to identify factors associated with complex surgical wounds in the breasts and abdomen in outpatients. Method:observational case-control study involving 327 patients, distributed into 160 cases (complex surgical wound) and 167 controls (simple surgical wound). Data were extracted from the medical records and a binary logistic regression model was used for analysis, considering a significance level of 5%. Results:the factors associated with greater chance of occurrence of complex surgical wound were 18 to 59 years of age (p = 0.003), schooling < 8 years (p = 0.049), radiotherapy (p < 0.001), hysterectomy (p = 0.003), glycemia (≤ 99 mg/dL) and arterial hypertension (p = 0.033), while quadrantectomy (p = 0.025) served as a protective factor. Conclusion:radiotherapy was the most significant factor for surgical wound complications. Glycemic alteration was an unexpected result and shows the need for further studies related to this topic.
Highlights
A surgical wound is characterized by an intentional rupture of the epithelial integrity of the skin and underlying structures
From the total of 327 patients submitted to breast or abdominal surgeries, 160 individuals presented complications in the surgical wound and composed the group of cases studied here, and the remaining (n = 167) patients who did not present complications composed the control group, in a 1: 1 ratio
In another study aimed at identifying postoperative complications in patients submitted to hysterectomy, sepsis due to hematoma of the surgical wound was identified in four patients among 98 submitted to abdominal hysterectomy[22]
Summary
A surgical wound is characterized by an intentional rupture of the epithelial integrity of the skin and underlying structures. Second intention wound healing happens when the surgical wound remains open after the surgery and the proliferative phase occurs to repair a greater tissue loss. Third intention healing happens when the surgical wound is left open for a short period of time and the re-approximation of the edges is performed later[1]. As an aggravating factor to the epidemiological scenario of complex wounds, a recent study in the rural community of Rwanda, Africa, pointed to a probable underestimation of data due to the persistent inequities in access to surgical procedures, especially in low- and middle-income countries[7]. Epidemiological data regarding complex surgical wounds are scarce and the existing ones approach the subject in general way, without specifying the site of occurrence, as for example, in abdomen and breasts
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