The feasibility of the application of the accelerated surgical recovery protocol (PROSM) in patients undergoing thoracic surgical procedures

Introduction:Chagasic Megaesophagus (CME) is the manifestation of the disease characterized by luminal enlargement and muscular hypertrophy. Physiotherapy is an area that can be beneficial to CME patients in both pre and postoperative stages due to evidence of its success rate in preventing pulmonary complications. Objective:analyze the use of physiotherapeutic treatment in treating patients that underwent surgical treatment for CME. Methods: Study developed at University Federal of Goiás- Hospital das Clínicas, in Goiânia – Goiás. Of the 1096 surgical procedures, 38 of them were to treat CME. Results: was an average age of 59,4±13 years, 77% male and 23% female, physiotherapeutic care was part of the postoperative routine in 68% of the cases with no record of its occurrence in the preoperative stages.Conclusion: Physiotherapy was used only in the postoperative stage. Despite the importance of Physiotherapy in the treatment of CME, the studies pertaining to its use in this context are scarce. As a result, more research is necessary to emphasize that its use from the moment of hospitalization could increase the possibilities of surgical recovery.

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Surgical site infection incidence and risk factors in thoracic surgical procedures: A 12-year prospective cohort study

The Journal of Infection in Developing Countries ◽

10.3855/jidc.11240 ◽

2019 ◽

Vol 13 (03) ◽

pp. 212-218

Author(s):

Vlado S Cvijanovic ◽

Aleksandar S Ristanović ◽

Nebojsa T Maric ◽

Natasa V Vesovic ◽

Vanja V Kostovski ◽

...

Keyword(s):

Risk Factors ◽

Thoracic Surgery ◽

Surgical Procedures ◽

Surgical Site Infections ◽

Thoracic Surgical Procedures ◽

Wound Contamination ◽

Surgical Site Infection Incidence ◽

Independent Risk Factors ◽

American Society ◽

Duration Of Operation

Introduction: Surgical site infections (SSI) continue to be a major problem for thoracic surgery patients. We aimed to determine incidence rate (IR) and risk factors for SSI in patients with thoracic surgical procedures. Methodology: During 12 years of hospital surveillance of patients with thoracic surgical procedures, we prospectively identified SSI. Patients with SSI were compared with patients without SSI. Results: We operated 3,370 patients and 205 (6.1%) developed SSI postoperatively. We detected 190 SSI among open thoracic surgical procedures (IR 7.1%) and 15 SSI after video-assisted thoracic surgery (IR 2.1%). Five independent risk factors for SSI were identified: wound contamination (p = 0.013; relative risk (RR) 2.496; 95%, confidence interval (CI): 1.208-5.156), American Society of Anesthesiologist (ASA) score (p = 0.012; RR: 1.795; 95% CI: 1.136-2.834), duration of drainage (p < 0.001; RR: 1.117; 95% CI: 1.085-1.150), age (p = 0.036; RR: 1.018; 95% CI: 1.001-1.035) and duration of operation (p < 0.001; RR:1.005; 95% CI:1.002-1.008). Conclusion: The results are valuable in documenting risk factors for SSI in patients undergoing thoracic surgery. The knowledge and prevention of controllable risk factors is necessary in order to reduce the incidence of SSI.

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