Abstract
ABSTRACTObjective: to estimate the healing rate of complex surgical wounds and its associated factors. Method: retrospective cohort study from 2003 to 2014 with 160 outpatients of a Brazilian university hospital. Data were obtained through consultation of the medical records. Survival function was estimated using the Kaplan-Meier method and Cox regression model to estimate the likelihood of the occurrence of healing. Results: the complex surgical wound healing rate was 67.8% (95% CI: 60.8-74.9). Factors associated with a higher likelihood of wound healing were segmentectomy/quadrantectomy surgery, consumption of more than 20 grams/day of alcohol, wound extent of less that 17.3 cm2 and the length of existence of the wound prior to outpatient treatment of less than 15 days, while the use of hydrocolloid covering and Marlex mesh were associated with a lower likelihood of healing. Conclusion: the wound healing rate was considered high and was associated with the type of surgical intervention, alcohol consumption, type of covering, extent and length of wound existence. Preventive measures can be implemented during the monitoring of the evolution of the complex surgical wound closure, with possibilities of intervention in the modifiable risk factors.
Highlights
MethodVarious international guidelines are available for chronic wounds, such as venous, arterial and pressure ulcers and diabetic foot ulcers, with recommendations for the prevention and treatment of these wounds
This study aimed to estimate the complex surgical wound healing rate and identify the factors associated with the healing of these wounds in patients monitored in a Brazilian tertiary hospital
The sample presented low levels of education and family income, with alcohol consumption above 20 grams/day being observed in 5.0% of the patients and smoking in 22.5%
Summary
MethodVarious international guidelines are available for chronic wounds, such as venous, arterial and pressure ulcers and diabetic foot ulcers, with recommendations for the prevention and treatment of these wounds. For wounds of acute etiology, e.g., surgical wounds, there are few care recommendations, which generates a variety of actions in the practice, without the clarity regarding specific factors that assist or delay the cicatrization process. Associated with this fact, the large number of dressings available, the large number of health professionals involved, and the many opinions regarding effective wound care must be considered[1]. Surgical wounds (SW) are considered acute, planned and carried out with overlapping edges, which heal by primary intention and have a tendency to regress spontaneously and complete within the expected period. When there is no edge proximity the healing of surgical wounds is by secondary intention. These wounds require more time to heal due to the space between the edges and need greater granulation tissue formation for completion until contraction and epithelialization occur[2]
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