Prevenzione delle infezioni del sito chirurgico in ginecologia e ostetricia: una revisione di letteratura e una proposta di algoritmo gestionale

Ricevuto: 25 aprile 2024
Accettato: 4 luglio 2024
Published: 26 agosto 2024
Abstract Views: 167
PDF: 118
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Le complicanze del sito chirurgico sono un importante problema sanitario irrisolto, con un impatto negativo sul decorso post-operatorio delle pazienti e sulla spesa sanitaria pubblica. Attualmente mancano chiare indicazioni sulle strategie preventive delle infezioni del sito chirurgico (Surgical Site Infection, SSI) in chirurgia ginecologica e ostetrica; pertanto, presentiamo una revisione della letteratura e proponiamo un algoritmo per la gestione della ferita chirurgica in questo ambito. È stata condotta una revisione della letteratura comprendente i lavori pubblicati in lingua inglese tra il gennaio 1965 e febbraio 2022 sulla prevenzione delle infezioni del sito chirurgico in seguito a chirurgia ostetrica o ginecologica. Complessivamente sono state identificate 118 pubblicazioni. Sono stati considerati rilevanti solo i lavori che descrivevano strategie preventive per le infezioni del sito chirurgico (n = 27). Alla fine sono stati inclusi e analizzati in questa revisione 8 studi. Proponiamo un algoritmo basato sui fattori di rischio identificati. In base alla categoria di rischio, viene identificato il tipo di medicazione post-operatoria più adeguata per la singola paziente. Infine, utilizzando una scheda dedicata, abbiamo proposto anche di valutare l’efficacia della medicazione utilizzata, in relazione sia alle caratteristiche della ferita nella visita post-operatoria, sia al grado di comfort e soddisfazione espresso dalla paziente. L’identificazione di chiari fattori di rischio e di una specifica condotta preventiva, adattata alla singola paziente, ha lo scopo di facilitare il medico nella gestione quotidiana della ferita chirurgica, migliorando l’esito dell’intervento. Il nostro sforzo principale è quello di ottenere uno strumento semplice nella gestione della ferita chirurgica per diffonderlo nella nostra pratica clinica. 

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Come citare

Surace, A., Mauro, J., Tripodi, E., Perotto, S., Borghi, C., Paracchini, S., … Buda, A. A. (2024). Prevenzione delle infezioni del sito chirurgico in ginecologia e ostetricia: una revisione di letteratura e una proposta di algoritmo gestionale. Italian Journal of Wound Care, 8(2). https://doi.org/10.4081/ijwc.2024.114