Revista SOBECC

Profile of surgical site infections in cancer patients undergoing conventional abdominal surgeries

2025-04-14T16:09:20-03:00

Objective: To characterize the profile of Surgical Site Infection (SSI) cases in oncological surgical patients undergoing elective conventional abdominal surgeries. Methods: A retrospective cohort study analyzed elective conventional abdominal surgeries performed from 2020 to 2021. SSI cases were identified according to the criteria set by the Center for Epidemiological Surveillance of the state of São Paulo. Results: A total of 100 surgical procedures were analyzed, and 19 SSI cases were identified, with the majority being organ/site infections. The profile of patients affected by SSI consisted mainly of male individuals, with comorbidities (ASA 3), smokers, and those diagnosed with spleno-pancreatic or hepatic neoplasia. The risk factors associated with SSI included the duration of the procedure (p=0.015) and surgical re-intervention (p<0.001). The most frequently identified microorganism was Enterococcus faecalis, followed by Gram-negative bacteria. The most commonly used antibiotic for treatment was ceftriaxone. Conclusion: The patient profile was associated with the presence of comorbidities, spleno-pancreatic neoplasia diagnosis, longer anesthetic-surgical procedure duration, and surgical re-intervention. The majority of cases were classified as organ/site infections, associated with Enterococcus faecalis and treated with ceftriaxone.

Post-operative complications between patients undergoing videolaparoscopic and robot-assisted gastroplasty

2025-06-08T13:15:03-03:00

Objective: To compare the occurrence of post-operative complications between patients undergoing gastroplasty by robot-assisted and videolaparoscopic (VLP) approaches. Methods: This is a case-control study. The electronic medical records of adult patients who underwent robot-assisted gastroplasty (case group) and VLP (control group) were included after electronic consent. Records of patients who had surgical technique conversion were excluded. The project was approved by the Research Ethics Committee of the institution where the research was conducted. Results: A total of 135 medical records were analyzed. The mean anesthetic time was 3h49 in the case group, compared to 2h10 in the control group (p<0.001). The average surgical time was 3h in the case group and 1h37 in the control group (p<0.001). The mean time spent in the post-anesthesia recovery room was 1h10 in the case group, compared to 1h07 in the control group (p=0.013). The occurrence of post-operative complications was similar between the study groups, with the most frequent being: pain (82; 60.7%), nausea (38; 28.1%), and vomiting (15; 11.1%). Conclusion: The post-operative complications assessed were similar between the groups. Patients undergoing VLP gastroplasty had significantly shorter anesthetic-surgical times compared to those undergoing robot-assisted surgeries.

Perspectives of the surgical team on patient safety culture in surgical centers

2025-08-19T11:44:13-03:00

Objective: To evaluate the safety culture in the surgical setting and to identify, together with the team, information that can support the development of strategies to promote and strengthen safe practices in the surgical environment. Methods: This is a quantitative, descriptive study conducted with operating room staff at a philanthropic hospital located in southern Brazil. Data were collected between May and September 2022 using the Hospital Survey on Patient Safety Culture questionnaire. Statistical tests were used for data analysis. Results: The study included 89 professionals, of whom 44.9% belonged to the nursing team and 46.1% to the medical team. The overall rating attributed to patient safety was considered “very good,” with a score of 60.6%. The dimensions “organizational learning” and “hospital management support for patient safety” achieved the highest mean scores (3.73). The dimensions “frequency of reported events,” “teamwork,” and “non-punitive response to errors” showed the lowest performance. Conclusion: The results highlighted the need to develop strategies to strengthen the multidisciplinary team, emphasizing the promotion of a safety culture to foster a safe surgical environment.

Pressure ulcer risk due to surgical positioning in adults and older adults

2025-06-17T15:50:51-03:00

Objective: To compare the risk of adult and elderly patients undergoing elective surgeries developing pressure injuries (PI) due to surgical positioning according to the ELPO scale. Method: A cross-sectional, descriptive study with a quantitative approach and an intentional non-probabilistic sample, composed of individuals undergoing surgeries of different specialties in a tertiary-level hospital located in the interior of São Paulo, Brazil. Data collection was conducted during the immediate preoperative and intraoperative periods. For statistical analysis, the Chi-square test, Student's t-test, and univariate logistic regression were performed, considering p<0.05 as the significance level. Results: The mean ELPO score among the 143 participants was 16.08 for adults and 18.62 for the elderly (p=0.0003), and 11.69% of adults and 34.85% of the elderly (p=0.0009) had a higher risk for PI. An increase of one year in age implies a 1.035-fold increase (p=0.0215) in the likelihood of the patient having a higher final mean score on the ELPO scale. Conclusion: Elderly patients have a higher risk of developing PI due to surgical positioning compared to adults.

Drying of endoscopes and its implication for microbial contamination: how safe is the use?

2025-08-05T14:47:47-03:00

Objetivo: Avaliar as práticas de secagem implementadas pelos serviços de endoscopia e determinar a ocorrência de crescimento microbiológico em equipamentos prontos para uso. Métodos: Trata-se de um estudo transversal, envolvendo a avaliação da etapa de secagem dos endoscópios em oito serviços de endoscopia gastrointestinal. O processamento de 22 endoscópios gastrointestinais foi monitorado, e uma avaliação microbiológica foi realizada em 60 canais de endoscópios após a desinfecção de alto nível e o armazenamento subsequente. Resultados: A secagem externa não foi realizada em 50,0% (11/22) dos equipamentos após a limpeza, e 27,2% (6/22) não passaram por secagem interna dos canais. A contaminação foi detectada em 21,9% (7/32) das amostras de canais de endoscópios armazenados, com cargas microbianas variando de 2,0x10¹ a 2,5x10⁵ UFC/mL. Além disso, 32,1% (9/28) dos canais apresentaram crescimento microbiano após a desinfecção de alto nível, com cargas microbianas variando de <10¹ a um máximo de 1,3x10³UFC/mL. A Pseudomonas sp. foi responsável por 50,0% (6/12) dos micro-organismos isolados encontrados nos canais do endoscópio. Conclusão: A presença de agentes infecciosos associada às práticas inadequadas, especialmente durante a secagem, evidentemente contribui para a persistência da contaminação microbiana nos endoscópios, representando um risco para os pacientes subsequentes.

Climate catastrophe in Rio Grande do Sul: impact on sterile processing departments

2025-03-28T16:21:36-03:00

Objective: To report the experience of nurses in sterile processing departments in three large hospitals in Rio Grande do Sul, Brazil during a climate catastrophe. Methods: Experience report of nurses working in sterile processing departments regarding contingency measures for the operation of three class II sterile processing departments, designated institutions A, B and C, in Southern Brazil, during a climate catastrophe. Results: The three institutions adopted contingency measures to mitigate the impacts of the climate disaster. The activities of the hospitals remained restricted, with one of them temporarily closing. Power generators were used, and water supply and health product processing were outsourced. To ensure the well-being of employees, different working hours and transportation were adopted. All institutions mapped their employees carrying out solidarity actions. Conclusion: Similarities and differences were observed in the ways of managing three sterile processing departments under the deleterious effects caused by the climate catastrophe. It was evident that the three institutions shared a commitment to humanized care for personnel and safety, maintaining rigorous control standards to ensure excellence in service.

Implementation of Neonpass OR for digital communication and process automation in the operating room

2025-07-25T11:59:44-03:00

Objective: To report the implementation process of a digital solution for communication between the operating room and support areas, integrated with the automation of room turnover processes.
Method: Experience report on the implementation of the digital solution Neonpass OR® in a private philanthropic hospital in São Paulo, conducted in two phases: (1) implementation on August 12, 2024, and (2) follow-up until November 30, 2024.
Results: The solution was used in 25 operating rooms, totaling 74,088 activations, involving professionals from nursing, radiology, hygiene, hemotherapy, clinical engineering, and pharmacy. The most frequent requests were directed to pharmacy (24.3%), clinical engineering (17.5%), and the circulating nurse (15.4%), with a median response time of 15 minutes.
Conclusion: The experience with the implementation of Neonpass OR® demonstrated potential to improve communication between the surgical center and support areas, as well as to facilitate the reorganization of workflows related to room turnover, with positive feedback from the involved teams.

Artificial intelligence: potential and challenges for perioperatirve nursing

2025-04-09T09:49:24-03:00

The Role of Perioperative Nursing in Global Health

2025-04-07T16:28:21-03:00

For a culture of peace in the operating room: nonviolent communication as an ally for safe care

2025-09-18T20:53:31-03:00