Öz
Surgical site infections are one of the most important issues of surgery that increase mortality, morbidity, length of hospital stay and hospital expenses. Surgical incision dressings; It is believed to represent a mechanical and/or microbial barrier to theoretically prevent the migration of microorganisms from the skin to the surgical site during surgeries. Therefore, surgical incision drapes are widely used in the operating room to reduce contamination of the surgical site. Compliance with evidence-based recommendations for the prevention of surgical site infection is very important in reducing infection rates. Operating room nurses, who are part of the surgical team, are primarily responsible for the control of surgical site infections in operating rooms. Therefore, operating room nurses; It is important that they have knowledge of the literature and evidence-based guideline recommendations regarding surgical incision dressings, the use of which is a controversial issue. In this article, it is aimed to include studies on the effectiveness of surgical incision dressings in preventing surgical site infections in the light of recent updates and recommendations on surgical incision dressings in clinical guidelines. As a result, in the literature on the use of surgical incision dressings and in the current international guidelines published to prevent surgical site infections; It has been observed that there is no single consensus on the use of surgical incision dressings in the operating room, but in the case of the use of surgical incision dressings, it is recommended to use iodine-impregnated surgical incision dressings. It is recommended that more studies be conducted on this subject in order to contribute to the attempts to prevent surgical site infections and to bring the use of surgical incision dressing to the literature. In addition, it is recommended that operating room nurses should follow current information on the use of surgical incision dressings and try to prevent surgical site infections.
Anahtar Kelimeler
Kaynakça
- Apsic. (2019). The apsic guidelines for the prevention of surgical site infections. The Asia Pacific Society of Infection Control. Retrieved from https://apsic-apac.org/wp-content/uploads/2019/02/APSIC-SSI-Prevention-guideline-Feb-2019.pdf
- Barbara, D. W., Dietz, N. M., White, R. D., Pochettino, A., & Nuttall, G. A. External defibrillation failure due to antimicrobial incise drape, 88 Mayo Clinic Proceedings 1032–1034 (2013). Elsevier Ltd. Retrieved from https://doi.org/10.1016/j.mayocp.2013.06.018
- Bashaw, M. A., & Keister, K. J. (2019). Surgical Site Infections. AORN Journal, 109(1), 68–78. Retrieved 11 May 2020 from https://doi.org/10.1002/aorn.12451
- Bejko, J., Tarzia, V., Carrozzini, M., Gallo, M., Bortolussi, G., Comisso, M., … Bottio, T. (2015). Comparison of efficacy and cost of iodine impregnated drape vs. standard drape in cardiac surgery: study in 5100 patients. Journal of Cardiovascular Translational Research, 8, 431–437.
- Casey, A. L., Karpanen, T. J., Nightingale, P., Conway, B. R., & Elliott, T. S. J. (2015). Antimicrobial activity and skin permeation of iodine present in an iodine-impregnated surgical incise drape. Journal of Antimicrobial Chemotherapy, 2–6. Retrieved from https://doi.org/10.1093/jac/dkv100
- Cdc. (2017). Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. Jama surgery. Retrieved from doi:10.1001/jamasurg.2017.0904
- Eckler, R., Quist-Nelson, J., Saccone, G., Ward, H., & Berghella, V. (2019). Adhesive incisional drapes during cesarean delivery for preventing wound infection: A systematic review and meta-analysis of randomized controlled trials. European Journal of Obstetrics and Gynecology and Reproductive Biology: X, 4, 100090.
- Grove, G. L., & Eyberg, C. I. (2012). Comparison of two preoperative skin antiseptic preparations and resultant surgical incise drape adhesion to skin in healthy volunteers. Journal of Bone and Joint Surgery - Series A, 94(13), 1187–1192.
- Hanada, M., Hotta, K., Furuhashi, H., & Matsuyama, Y. (2020). Intraoperative bacterial contamination in total hip and knee arthroplasty is associated with operative duration and peeling of the iodine-containing drape from skin. European Journal of Orthopaedic Surgery and Traumatology, 30(5), 917–921. Retrieved from https://doi.org/10.1007/s00590-020-02653-y
- Hesselvig, A. B., Arpi, M., Madsen, F., Bjarnsholt, T., & Odgaard, A. (2020). Does an Antimicrobial Incision Drape Prevent Intraoperative Contamination? A Randomized Controlled Trial of 1187 Patients. Clinical Orthopaedics and Related Research, 478(5), 1007–1015. Retrieved from https://doi.org/10.1097/CORR.0000000000001142
- Jci. (2018). Evidence-based principles and practices for preventing surgical site infections. Joint Commission International. Retrieved from https://www.jointcommissioninternational.org/-/media/jci/jci-documents/offerings/advisory-services/infection-prevention-and-control/jci_ssi_toolkit.pdf?db=web&hash=51FCBF18BC050870C6721734A67F79ED
- Jolivet, S., & Lucet, J. C. (2019). Surgical field and skin preparation. Orthopaedics and Traumatology: Surgery and Research, 105(1), S1–S6.
- Karapinar, K., & Kocatürk, C. I. (2019). The Effectiveness of Sterile Wound Drapes in the Prevention of Surgical Site Infection in Thoracic Surgery. BioMed Research International, 2019, 1–7. Retrieved from https://doi.org/10.1155/2019/1438793
- Kumar, A., & Gandhi, S. (2011). Surgical adhesive incise drapes and defibrillation during cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 25(2), 387–388. Retrieved from https://doi.org/10.1053/j.jvca.2009.12.016
- Kuo, F. C., Tan, T. L., Wang, J. W., Wang, C. J., Ko, J. Y., & Lee, M. S. (2020). Use of antimicrobial-impregnated incise drapes to prevent periprosthetic joint infection in primary total joint arthroplasty: a retrospective analysis of 9774 cases. Journal of Arthroplasty, 30, 1–6.
- Milandt, N., Nymark, T., Jørn Kolmos, H., Emmeluth, C., & Overgaard, S. (2016). Iodine-impregnated incision drape and bacterial recolonization in simulated total knee arthroplasty: a controlled, randomized experimental trial. Acta Orthopaedica, 87(4), 380–385.
- Nice. (2019). Surgical site infections: prevention and treatment nice guideline. Retrieved from https://www.nice.org.uk/guidance/ng125/resources/surgical-site-infections-prevention-and-treatment-pdf-66141660564421
- Rezapoor, M., Tan, T. L., Maltenfort, M. G., & Parvizi, J. (2018). Incise draping reduces the rate of contamination of the surgical site during hip surgery: a prospective, randomized trial. Journal of Arthroplasty, 33(6), 1891–1895.
- Scheidt, S., Walter, S., Randau, T., Köpf, U. S., Jordan, M. C., & Hischebeth, G. T. R. (2020). The influence of iodine impregnated incision drapes on the bacterial contamination of scalpel blades in joint arthroplasty. The Journal of Arthroplasty.
- Webster, J., & Alghamdi, A. (2015). Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database of Systematic Reviews. Retrieved from 10.1002/14651858.CD006353.pub4.
- Who. (2018). Who surgical site infection prevention guidelines Web appendix 17 summary of a systematic review on drapes and gowns. Retrieved from https://www.who.int/gpsc/appendix17.pdf?ua=1
- Yoshimura, Y., Kubo, S., Hirohashi, K., Ogawa, M., Morimoto, K., Shirata, K., & Kinoshita, H. (2003). Plastic iodophor drape during liver surgery operative use of the iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery. World Journal of Surgery, 27(6), 685–688. Retrieved from https://doi.org/10.1007/s00268-003-6957-0
- Zarei, M., Tabesh, H., Fazeli, H., & Aarabi, A. (2019). Effect of Incise Drape on Contamination Rate of Surgical Wound during Surgical Procedures of Lumbar Spine. Advanced Biomedical Research, 8(8), 1–8. Retrieved 14 May 2020 from https://doi.org/10.4103/abr.abr_226_18
Öz
Cerrahi alan enfeksiyonları mortaliteyi, morbiditeyi, hastanede yatış süresini ve hastane giderlerini arttıran cerrahinin en önemli konularından birisidir. Cerrahi kesi örtülerinin; ameliyatlar sırasında teorik olarak mikroorganizmaların deriden ameliyat bölgesine göçünü önlemek için mekanik ve / veya mikrobik bir bariyeri temsil ettiğine inanılmaktadır. Bu nedenle cerrahi kesi örtüleri ameliyathanede cerrahi bölge kontaminasyonunu azaltmak için yaygın olarak kullanılmaktadır. Cerrahi alan enfeksiyonunun önlenmesine yönelik kanıta dayalı önerilere uyulması, enfeksiyon oranlarının düşmesinde oldukça önemlidir. Cerrahi ekibin bir parçası olan ameliyathane hemşireleri ameliyathanelerde cerrahi alan enfeksiyonlarının kontrolünde primer sorumlu kişilerdir. Dolayısıyla ameliyathane hemşirelerinin; kullanımı tartışmalı bir konu olan cerrahi kesi örtülerine ilişkin literatür ve kanıta dayalı rehber önerileri hakkında bilgi sahibi olmaları önem arz etmektedir. Bu makalede, son güncellemeler ışığında cerrahi alan enfeksiyonlarını önlemede cerrahi kesi örtülerinin etkinliği ile ilgili yapılmış çalışmalar ve klinik rehberlerde yer alan cerrahi kesi örtüleri ile ilgili önerilere yer verilmesi amaçlanmıştır. Sonuç olarak, cerrahi kesi örtülerin kullanımına yönelik literatür ve cerrahi alan enfeksiyonlarını önlemek amacıyla yayınlanan uluslararası güncel rehberlerde; ameliyathanede cerrahi kesi örtülerin kullanımına yönelik tek bir fikir birliğinin olmadığı, ancak cerrahi kesi örtülerinin kullanımı durumunda ise özellikle iyot emdirilmiş cerrahi kesi örtülerin kullanılmasının önerildiği görülmüştür. Cerrahi kesi örtüsü kullanımının cerrahi alan enfeksiyonlarını önleme girişimlerine katkı sağlaması ve literatüre kazandırılması için bu konuda daha fazla çalışma yapılması önerilmektedir. Ayrıca ameliyathane hemşirelerinin cerrahi kesi örtülerin kullanımına yönelik güncel bilgileri takip ederek cerrahi alan enfeksiyonlarını önleme girişimlerinde bulunmaları önerilmektedir.
Anahtar Kelimeler
yapışkan cerrahi bant enfeksiyon cerrahi yara adhesive surgical tape infection surgical wound
Kaynakça
- Apsic. (2019). The apsic guidelines for the prevention of surgical site infections. The Asia Pacific Society of Infection Control. Retrieved from https://apsic-apac.org/wp-content/uploads/2019/02/APSIC-SSI-Prevention-guideline-Feb-2019.pdf
- Barbara, D. W., Dietz, N. M., White, R. D., Pochettino, A., & Nuttall, G. A. External defibrillation failure due to antimicrobial incise drape, 88 Mayo Clinic Proceedings 1032–1034 (2013). Elsevier Ltd. Retrieved from https://doi.org/10.1016/j.mayocp.2013.06.018
- Bashaw, M. A., & Keister, K. J. (2019). Surgical Site Infections. AORN Journal, 109(1), 68–78. Retrieved 11 May 2020 from https://doi.org/10.1002/aorn.12451
- Bejko, J., Tarzia, V., Carrozzini, M., Gallo, M., Bortolussi, G., Comisso, M., … Bottio, T. (2015). Comparison of efficacy and cost of iodine impregnated drape vs. standard drape in cardiac surgery: study in 5100 patients. Journal of Cardiovascular Translational Research, 8, 431–437.
- Casey, A. L., Karpanen, T. J., Nightingale, P., Conway, B. R., & Elliott, T. S. J. (2015). Antimicrobial activity and skin permeation of iodine present in an iodine-impregnated surgical incise drape. Journal of Antimicrobial Chemotherapy, 2–6. Retrieved from https://doi.org/10.1093/jac/dkv100
- Cdc. (2017). Centers for disease control and prevention guideline for the prevention of surgical site infection, 2017. Jama surgery. Retrieved from doi:10.1001/jamasurg.2017.0904
- Eckler, R., Quist-Nelson, J., Saccone, G., Ward, H., & Berghella, V. (2019). Adhesive incisional drapes during cesarean delivery for preventing wound infection: A systematic review and meta-analysis of randomized controlled trials. European Journal of Obstetrics and Gynecology and Reproductive Biology: X, 4, 100090.
- Grove, G. L., & Eyberg, C. I. (2012). Comparison of two preoperative skin antiseptic preparations and resultant surgical incise drape adhesion to skin in healthy volunteers. Journal of Bone and Joint Surgery - Series A, 94(13), 1187–1192.
- Hanada, M., Hotta, K., Furuhashi, H., & Matsuyama, Y. (2020). Intraoperative bacterial contamination in total hip and knee arthroplasty is associated with operative duration and peeling of the iodine-containing drape from skin. European Journal of Orthopaedic Surgery and Traumatology, 30(5), 917–921. Retrieved from https://doi.org/10.1007/s00590-020-02653-y
- Hesselvig, A. B., Arpi, M., Madsen, F., Bjarnsholt, T., & Odgaard, A. (2020). Does an Antimicrobial Incision Drape Prevent Intraoperative Contamination? A Randomized Controlled Trial of 1187 Patients. Clinical Orthopaedics and Related Research, 478(5), 1007–1015. Retrieved from https://doi.org/10.1097/CORR.0000000000001142
- Jci. (2018). Evidence-based principles and practices for preventing surgical site infections. Joint Commission International. Retrieved from https://www.jointcommissioninternational.org/-/media/jci/jci-documents/offerings/advisory-services/infection-prevention-and-control/jci_ssi_toolkit.pdf?db=web&hash=51FCBF18BC050870C6721734A67F79ED
- Jolivet, S., & Lucet, J. C. (2019). Surgical field and skin preparation. Orthopaedics and Traumatology: Surgery and Research, 105(1), S1–S6.
- Karapinar, K., & Kocatürk, C. I. (2019). The Effectiveness of Sterile Wound Drapes in the Prevention of Surgical Site Infection in Thoracic Surgery. BioMed Research International, 2019, 1–7. Retrieved from https://doi.org/10.1155/2019/1438793
- Kumar, A., & Gandhi, S. (2011). Surgical adhesive incise drapes and defibrillation during cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 25(2), 387–388. Retrieved from https://doi.org/10.1053/j.jvca.2009.12.016
- Kuo, F. C., Tan, T. L., Wang, J. W., Wang, C. J., Ko, J. Y., & Lee, M. S. (2020). Use of antimicrobial-impregnated incise drapes to prevent periprosthetic joint infection in primary total joint arthroplasty: a retrospective analysis of 9774 cases. Journal of Arthroplasty, 30, 1–6.
- Milandt, N., Nymark, T., Jørn Kolmos, H., Emmeluth, C., & Overgaard, S. (2016). Iodine-impregnated incision drape and bacterial recolonization in simulated total knee arthroplasty: a controlled, randomized experimental trial. Acta Orthopaedica, 87(4), 380–385.
- Nice. (2019). Surgical site infections: prevention and treatment nice guideline. Retrieved from https://www.nice.org.uk/guidance/ng125/resources/surgical-site-infections-prevention-and-treatment-pdf-66141660564421
- Rezapoor, M., Tan, T. L., Maltenfort, M. G., & Parvizi, J. (2018). Incise draping reduces the rate of contamination of the surgical site during hip surgery: a prospective, randomized trial. Journal of Arthroplasty, 33(6), 1891–1895.
- Scheidt, S., Walter, S., Randau, T., Köpf, U. S., Jordan, M. C., & Hischebeth, G. T. R. (2020). The influence of iodine impregnated incision drapes on the bacterial contamination of scalpel blades in joint arthroplasty. The Journal of Arthroplasty.
- Webster, J., & Alghamdi, A. (2015). Use of plastic adhesive drapes during surgery for preventing surgical site infection. Cochrane Database of Systematic Reviews. Retrieved from 10.1002/14651858.CD006353.pub4.
- Who. (2018). Who surgical site infection prevention guidelines Web appendix 17 summary of a systematic review on drapes and gowns. Retrieved from https://www.who.int/gpsc/appendix17.pdf?ua=1
- Yoshimura, Y., Kubo, S., Hirohashi, K., Ogawa, M., Morimoto, K., Shirata, K., & Kinoshita, H. (2003). Plastic iodophor drape during liver surgery operative use of the iodophor-impregnated adhesive drape to prevent wound infection during high risk surgery. World Journal of Surgery, 27(6), 685–688. Retrieved from https://doi.org/10.1007/s00268-003-6957-0
- Zarei, M., Tabesh, H., Fazeli, H., & Aarabi, A. (2019). Effect of Incise Drape on Contamination Rate of Surgical Wound during Surgical Procedures of Lumbar Spine. Advanced Biomedical Research, 8(8), 1–8. Retrieved 14 May 2020 from https://doi.org/10.4103/abr.abr_226_18
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Hemşirelik, Sağlık Kurumları Yönetimi |
| Bölüm | Derleme |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Aralık 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 5 Sayı: 2 |
