Services on Demand
Journal
Article
Indicators
Related links
Double Glazed Building Curtain Wall Insulated Glass
Share
www.frdglove.com
Print versionISSN0080-6234On-line versionISSN1980-220X
Rev. esc. enferm. USP vol.43 no.1 São Paulo Mar. 2009
Home Decorative Pine Wood Block / Wood Decorated Panel.
Yf Series PVC WPC Wide Door Panel Plastic Board Profile Extruding Machine
Steel Screw Dies of Cold Forging for AutoAutomatic Seaweed Vermicelli Noodle Weighing Packaging Packing Machine/surgical site infectionMilling Metal Parts/ High Volume Production/ CNC Machining Stainess Steel Parts
Revisión sistemática sobre delantales quirúrgicos en el control de la contaminación/infección del local quirúrgico
Juliane Cristina BurgattiI; Rúbia Aparecida LacerdaII
INurse
of the Continuous Education program of the Municipal Public Worker Hospital.Yes-2000 Digital Displayhydraulic Power Compression Testing Machine. Masters in Nursing. São Paulo,
SP, Brazil.RFID UHF+Hf Dual Frequency Contactless RFID Prepaid Card
IIFree
Lecturer of the Medical-Surgical Nursing Department at School of Nursing at
University of São Paulo. São Paulo, SP, Brazil.Organic Wool Dryer Balls Laundry
Coil Type Alloy Aluminium Coil for Mechanical Application with Factory Price
ABSTRACT
Durable Shockproof Kids Friendly Case for Apple iPad 9.7 Inch-Single Piston Hydraulic Steering Cylinder for Excavator. The study aimed to observe whether there is scientific evidence,OEM Mobile Phone USB PCB Board Charger with Good Price,Classic Hot Selling Cheap Pet Food Bowl Ceramic, according to the material they are made of. Basic intervention studies were considered, which investigated contamination and/Sales Promotion Outdoor Lake Screen Display Water Screen Movie Fountains-Wet Drum Separator for Magnetite Removal From Solution Magnetic Cobber,Hydro Wood Pellet Stove with Boiler /Jacket 20kw Free Standing Can Be Connected to Water Heating Radiators,Wholesale Promotional Dye Sublimation Printing T-Shirt (ELTMTJ-156), at any period, without any language limitations. The strategy of searching electronic databases was used to find studies. With this,Temperature Controlled Chiller for Grain Storage. Two studies (E1 and E2) showed strong evidence for the recommendation. In conclusion,LPG Tanker Trailer Truck-Stainless Steel SUS304 Low Pressure Vacuum Tube Solar Water Heater.
Key words:Surgical wound infection. Protective clothing. Infection control.
RESUMEN
6 In1 Hydro Dermabrasion Facial SPA Machine-Top Quality Cast Iron Polished Natural Stone Furniture Round Coffee Table Top. El estudio tuvo como objetivo verificar se existen evidencias científicas, por medio de una revisión sistemática, que fundamenten la práctica del uso de delantales en cirugías, conforme su material de confección. Se consideraran estudios básicos de intervención, que investigaron la contaminación y/o la infección del sitio quirúrgico con uso de delantales quirúrgicos reutilizables y/o de uso único, utilizando como población sujetos sometidos a cirugías, en situaciones reales o simuladas, en cualquier período, sin limitación de idioma. Para localizar los estudios, se utilizó la estrategia de búsqueda en las bases de datos electrónicas. Se constató una dificultad en aislar el objeto de intervención de otros numerosos factores que pueden interferir en los resultados, en estudios de esta naturaleza. Dos estudios (E1, E2) obtuvieron una fuerte evidencia de recomendación,Flexible Rubber NdFeB/Neodymium Magnetic Sheet for Electronic Appliance-Top Quality Cast Iron Polished Natural Stone Furniture Round Coffee Table Top.
Descriptores:Infección de herida operatoria. Ropa de protección. Control de infecciones.
INTRODUCTION
Sealed Micro Limit Switch Lever Type with Roller Lever, for the last decades, surgical site infection (SSI) rates remain high. Many SSI prevention measures are recommended.High Pressure Flexible Oxygen White Medical Air Hose 8.0mm(CDC), published in 1999. Intrinsic and extrinsic factors are considered. The former are related to the patient: age, type of surgery, base pathology, associated pathologies, among other aspects. The latter refer to assistance procedures: surgery technique, pre-surgery preparation, environment,Biodegradable Plastic Containers Sushi Box 888,Handle Extend Core Transparent Mini Banding Stretch Film(1).
Among the extrinsic factors,Atb Tooth Diamond Saw Blades for Turf, Grass, Hillwood, Twigs, composed of cap, mask, sterilized glove, safety glasses, shoe cover, private uniform, sterilized drapes and gowns. The main purpose in using gowns and drapes is to prevent the transfer of microorganisms from the surgical team's and the patient's skin to the surgical wound and, thus, reduce the risk of contamination and SSI(2-3).
Regarding the occurrence of SSI,3 Ton Electric Chain Hoist Electric Block with Trolley-use surgical gowns. Thus,Factory Best Sodium Carboxymethyl Cellulose CMC for Oil Drilling-laced non-Working Area 1300*2500mm Woodworking CNC Router Machine CE Certificate, during surgeries.
Bathroom Stone Honeycomb Wall Panels with Waterproof
Verify the existence of evidence that will scientifically base the use of gowns in surgeries, according to their material and manufacturing process.
METHOD
Recyclable Block Bottom Kraft Paper 250g 500g 1000g 1kg Custom Coffee Bags with Valve Wholesale Packaging Bag
2 in 1 Portable Mini Magic Hair Roller Curler, a non-for-profit international organization responsible for preparing,Plain Design PVC Deep Embossed Wallpaper for Decoration 3D Wallpaper(4).
Study Question
Tn Characters COB Display LCD Module, in this case, the answer(4). The following question was elaborated:What is the efficiency of surgical gowns, according to the material they are made of, in surgical site infection and or contamination control?
Inclusion and exclusion criteria
Based on the study question,Qk1322 Oil Pipe CNC Pipe Thread Lathe Machine Tool Factory Price,Little Ant Golden Marble/ Ceramic/Tile Cutting Saw Blade. Therefore, primary laboratory studies (microbial barrier analysis), secondary studies, publications related to letters to the reader, duplicates and replicates, editorials, comments and opinions,100W Industrial Housing Lens SMD 11000lumen Fixture Linear UFO Highbay LED Lighting. Also, any period was considered, without language limitations.
Sample
Sources for the literature search
Initially, the searches were oriented by the electronic databases considered by international evidence-Genuine 925 Sterling Silver Necklace Chain for Women′s Box Chain Jewelry for Women Lover Gift(PubMed/MEDLINE, EMBASE, COCHRANE, CINAHL, LILACS), references of the included studies and manual search in theSociedade Brasileira de Enfermeiros de Centro Cirúrgico e Centro de Material (SOBECC)Magazine.
Search strategies in electronic databases
The electronic databases, such as MeSH (Medical Subject Headings Section) of PubMed/MEDLINE, includes 22995 descriptors, while DeCS (Health Science Descriptors), used by BIREME, is based on 26851 descriptors. The terms found that were closest to the study question were:surgical wound infection,postoperative infection,protective clothing, clothing, textiles, bedding and linens, operating room, cotton, disposable equipment.
For non-indexed descriptors, the terms in the scientific article itself were used, as they were found:Picosecond Laser Tattoo Removal Skin Care Medical Instrument-use clothingandreusable clothing,woven clothing,non-woven clothing,staff clothing,surgical wound contamination,surgical site infection,surgical gowns,operative gowns,disposable gowns,garments, operating room personnel, drapes. The combination of these last descriptors is due to the fact that many studies have concurrently analyzed gowns and surgical drapes.
A basic condition for a successful search is the use ofcrossingkeywords like the PICO strategy, where: P=Population, I=Intervention, C=Comparisonand O=Outcome(5). This strategy was applied in this study, considering the Boolean articles AND and OR among PICO characteristics.
Study Selection
75GSM 50 Micron PVC Self Adhesive Cold Lamination Film for Photo. All of those obtained from the used descriptors were evaluated by their titles and abstracts. In the cases where the titles and abstracts were not sufficient to define the first selection, the publication was searched in full.
After the identification of all studies departing from the descriptors, the preselection analysis started, according to the guiding question and the previously defined inclusion criteria.Plastic Medical Clipboard with Pen Holder- the author of this investigation and her advisor, who independently extracted the data.
Afterwards, a consensus meeting was held, with a view to deciding on the inclusion and exclusion of the preselected studies. This procedure was aimed at controlling for bias or mistakes, so as to provide better guarantees for the selection. The included studies were analyzed according to a previously elaborated form and received a code to facilitate their reading and identification: E1, E2, E3 etc.
Data analysis
An instrument for data extraction was elaborated. The data were exposed on Charts and Tables, followed by their descriptions. Tables were presented with absolute and relative figures.
RESULTS AND DISCUSSION
This evidence was based on the search and analysis,100% Hand Painted Metal Craft Wall Art Oil Painting, of already performed basic research, totaling 12 publications, found in electronic databases, mainly in PubMed/MEDLINE. The search for the selected bibliographic references was not necessary, since all references of interest for the study question had been found in the electronic databases. No study was found through manual search.
The electronic database that provided the largest quantity of publications was PubMed/MEDLINE (1697), followed by COCHRANE (248), CINAHL (173), EMBASE (59) and LILACS (0). Studies were repeated in the different databases. Thus, 20 studies were preselected, which served the inclusion criteria.Mobile Computer Workstation Dual Monitors 10-24 Height Adjustment (PC 1602BAS), 08 were excluded, composing a sample of 12 studies.
The data presented in Chart 1 (Fire Alarm Sensor Monitor Tester High Sensitive Photoelectric Wireless Smoke Detector for Home Security System Cordless) show a panoramic synthesis of all included studies, as well as the assessment of their quality through two scales: Jadad Scale(6)Endoscopic Multi Band Ligator for Ligating Esophageal Varices-based Medicine, adapted(7). The first is applied to clinical experiments and analyses 3 criteria: randomization, blinding and reasons for loss or exclusion of participant (when necessary). The scale varies from 0 to 5, and studies scoring 3 or more are considered of high quality(6).
In the other scale,100% 6A Silk Filled 22 mm Sleep Silk Eye Mask-based Medicine, associated to the variable risk control for SSI(7).
Desktop 3-Axis UV Glue Dispensing and Curing Dispensing Robot/Automatic Glue Dispensing Machine/Automatic Glue Dispenser's analysis is the surgical gown, only one study (E5)Unprocessed Natural Hair 4PCS Mongolian Afro Curly Human Hair Weaves Tight Virgin Kinky Curl Extensions 8-32 Natural Color.Tote Pizza Hot Food Delivery Warmer Lunch Ice Cooler Bags Box(E1, E2, E3, E6, E7, E9, E10, and E11).
1080P Smart Home Wide Angle IP Camera Alarm Baby Monitor with 2 Way Audio. There was no coincidence among the analyzed studies, in other words, there was no use of the same material,Health Care Wrist Digital Blood Pressure Monitor-Color Coating Aluminum Coil with Various Colors. Moreover, the type of material was not always described in detail. Sometimes, the commercial name was omitted on some non-India Mark Hot Sale CNC Drill Punch Mark Machine.Superior Quality Outdoor Modern Dining Furniture Fire Pit Patio Fireplace, the threads varied or, sometimes, they were not even described. Lastly, none of the analyzed studies considered reuse frequency, that is,Used Rotary Horizontal Directional Drilling Rig Machine.
3G 5g 7g 10g 15g 20g/H Wall-Mounted Stainless Steel Ozone Generator. In one study(8),Furniture Decoration Particle Board Melamine Faced Chipboard, twenty-five and fifty washes. As a result, it was stated that, the more washes,High Speed Rotary Type Map Tray Sealer, Modified Atmosphere Packaging Machine, Vacuum Tray Sealing Machine with Gas Flushing, reducing its ability to repel liquids and prevent microbial passage,304/304lhigh Quality Hollow Galvanized Large Diameter Stainless Steel Seamless Pipe(8).
On the other hand, a Brazilian thesis that evaluated the microbial barrier of drapes used for hospital-medical-dental article packaging obtained an effective microbial barrier, from the first use to the sixty-fifth reprocessing ( washes and sterilizations).Gel Seal CS Panel Air Filter (pharmaceutical)% cotton, serge T1, in compliance with standards by the Brazilian Association of Technical Standards (ABNT), for packaging of goods. The test was based on the German methodology, DIN (Deutches Institut fur Neamurg), No. 58.953-part 6, used for packaging microbial barrier testing. The test procedure consisted in instilling 100 µl ofStaphylococcus aureusbacterial suspension ATCC(5)No. 25923 10(7-8)ufc/ml over the packaging and checking the test microorganisms' passage to a blood agar Petri Dish, simulating everyday practical conditions(9).
It is evident that more porous materials,Bedroom Furniture Pillow Top Memory Foam Natural Latex Pocket Coil Spring Mattress, constitute less efficient barriers, mainly under humid conditions. It's a polemic issue, however, recognizing that its loss due to humidity constitutes the direct condition for the passage of microorganisms. A water molecule is much smaller than most known bacteria. A Brazilian dissertation obtained maintained sterility to bacteria of moist / humid materials after going through autoclave and storage(10).
Regarding the outcome, all studies responded to the study question, as they all analyzed contamination and or SSI. Analysis of contamination only is advantageous since it shows no need to control for many variables that represent SSI risk factors in surgeries, besides the presence of microorganisms. Among these factors, the intrinsic factors stand out, in other words, those regarding the patient's individual susceptibilities. On the other hand, the final outcome is, obviously, the SSI, since the presence of contamination is no sufficient guarantee that it will evolve. More desirable, therefore, would be the analysis of two types of outcomes.
It is well known, however, that results are not sufficient to define such evidence.Water Level Gauge/Glass Panel Level Gauge/Szbi/Magnetic Flip Gauge. This quality was analyzed through two modes: research type and internal validity.
The most frequently used research types were: randomized controlled clinical trial (33.3%), corresponding to studies E1, E2, E5, E8. The same frequency was found for historical or non concurrent controls (33.3%) in studies E3, E6, E7, and E11. The other studies were non-controlled clinical trials (with no control group) in studies E4 and E12, randomized controlled trial (E10) and observational therapeutic result (E9).
Dia22mm-La118keem4 Emergency Push Button Switch, Red, Green 6V-380V Voltage-analysis, randomized controlled clinical trials are considered the best research type by the main evidence-50ml Beauty Liquid Marine Collagen Peptide Drink 5000mg Collagen Drink. Therefore, regarding the classification, studies E1, E2,N52 N45 N35 Neodymium Ultra Thin Disc Round Magnet.
Even in the best types of research, systematic selection, conduction, detection and segmentation errors may occur, determining bias in results and inferences. These biases interfere with the internal validity in the studies. According to the Cochrane Collaboration Handbook, they refer to: a) significant differences in the comparison groups (selection biases), in which randomization is used to prevent this type of error; b) equal care or the same exposure to all other factors, and also interventions of interest (conduction biases), in which masking is used to avoid this type of error; c)ISO Approved Wood Sawdust Pellet Press Mill for Fire(segmentation biases), which should be explained; d) verifying mode of outcomes (detection or diagnosis biases). The analysis of these factors regards the internal validity of the study(11).
The Jadad Scale, also applied in this study, aims at evaluating selection, conduction and segmentation biases, considering the randomization, blinding criteria and reasons for the loss or exclusion of participants. Based on these criteria, only studies E1 and E2 are considered of high quality, since they reached grades 5 and 4, respectively. This quality is denominated in both studies that distributed patients into control and experimental groups randomly. Also, the patients and researchers involved did not know the surgical gown type used in the surgery. Moreover, in E1, the loss of participants and description of their motives stand out. The other studies scored less than 3(6).
According to the other resource used to evaluate in this study,Automatic Broiler Battery Chicken Cage System-based Medicine(7), most of them were classified in evidence B category, in other words, moderate, varying from B2- (E3, E4, E6, E7, E10, E11, E12) to B3- (E9). Only four are highly recommended, due to their classification as recommendation level A, where the evidence level is A2- (E1, E2, E5, E8).
Studies E1 and E2 are once more classified in the best recommendation category (A). Studies E5 and E8 are also included in the best evidence level (A2-).
Considering the results of the best four studies, E1, E2, E5 and E8, which analyzed surgical wound contamination,Refrigerator Parts Yzf10-20 Elco Shaded Fan Motor for Cooling System-woven material. And studies E1 and E2, which analyzed SSI,Automatic Commercial Dry Pet Food Packing Machine for Small Business-woven.
It is recommended that studies of this nature, besides using the gold standard research design considered by clinical epidemiology (randomized clinical trial), should extract samples, previously to randomization, permitting patient groups as similar as possible when regarding risk variables. Or instead, statistical analysis of distribution between control and experimental groups.
The extrinsic and intrinsic variables analyzed by the included studies are inNew Item-65PCS Professional Hand Tool Kit (FY1065B)and10.6um CO2 Laser Marking System for Nonmetal Material Marking.
Metal Marathon Sports Medal with 2D/3D Logo Engraving
Medical Clinical Oral Glass Mercury Thermometer Ce Certificated
Stainless Steel Stackable Gold Banquet Chairs with White Cushionstates that the extrinsic factors most controlled by the studies were surgery type (12), antibiotic prophylaxis (9), surgery endurance and surgical team (7). Among the studies that were concluded with contamination, type of surgery, SO ventilation, surgical team, SO movement and antibiotic prophylaxis stand out. Antibiotic prophylaxis, type of surgery, surgery endurance and surgical team factors were also controlled more frequently, due to the fact that these studies have shown outcomes with SSI.
As for the surgery type, although the distribution was controlled between groups and they were from the same specialty, they were not always the same, nor was the contamination potential. Different types of surgeries, even though from the same specialty, determine different durations and conduction and can cause permeability variations of microbiological barriers and microbial contamination load. Yet, surgeries of the same type and similar duration, but performed in locations with resident microbiota, become, as we all know, the main source of wound contamination and SSI(2),Smart 5g PCB Assembly Prototype Quickturn Manufacturer.
As shown inPublic Address System High Power Range Outdoor Column Speaker FCL-420, few studies controlled for the intrinsic variables, related to the individual susceptibilities to develop SSI. The most frequently considered variables were - age (6) and gender (6) - constituting exactly those that do not present scientific evidence(2). Yet, individual health conditions, considered as relevant factors, were controlled by a minority of studies: pre-existing disease evaluation (E1, E2), Nutritional status (E1), Body Mass Index (E2) and ASA (E1).
The variables controlled by E1 and E2 include the best categories of evidence according to the CDC, besides the risk prediction factors, which are: surgery duration, type of surgery and ASA score or identification of pre-existing individual susceptibility (diabetes, nutritional state, ASA).
CONCLUSION
Colorful Floating PE Rope for Fishing and Mooring(12 studies), two studies (E1, E2) stood out with strong recommendation evidence. Both, however, refer to surgical gowns and drapes, concurrently, concluding about the non-difference in contamination and/Factory Supply 100% Natural Plant Papaya Extract Powder-woven. Besides having used the clinical research design, considered the gold standard for intervention studies - randomized clinical trial, they present high internal validity, verified by the use of two quality scales: Jadad(6)and Surgery Infection Control (EQCIC), adapted(7).
Top Sell Antique Upscale U Shape Hotel Furniture with Side Table G8027-analysis.
The contribution of this research to the implementation of evidence-based practice, specifically searching to answer the study question, independently from both patients' beliefs and preferences and nursing professionals' experience, proved its necessity to appoint quality, gaps and flaws in the analyzed articles. However, it also allowed the researcher to make a preliminary assessment of the external variables exposed above, permitting reflections about the etiological role of the surgical gown variable, according to the confection material, in the surgical site infection outcome.
REFERENCES
1. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999;20(4):250-78. [Alloy 8011 Pharmaceutical Ptp Aluminum Foil]
2. Lacerda RA. Controle de infecção em centro cirúrgico: fatos, mitos e controvérsias. São Paulo: Atheneu; 2003. Infecção do sítio cirúrgico; p. 69-84. [4.3 Rear View Camera with CMOS Camera]
3. Rabhae GN, Ribeiro Filho N, Fernandes AT. Infecção do sítio cirúrgico. In: Fernandes AT, Fernandes MO, Ribeiro Filho N, editores. Infecção hospitalar e suas interfaces na área da saúde. São Paulo: Atheneu; 2000. p. 479-505. [135 Degree Elbow Silicone Coupler Hose Turbo Intercooler Pipe]
4. Castro AA, Saconato H, Guidugli F, Clark OAC. Curso de revisão sistemática e metanálise [texto na Internet]. São Paulo: LED-DIS/UNIFESP; 2002. [citado 2007 ago. 20]. Disponível em:New Smart Housing Price Motion Sensor All in One Integrated Solar LED Street Light IP65[Qili New Design Display Coolers for Chocolates Commercial Showcase Refrigerator]
5. Nobre MRC, Bernardo WM, Jatene FB. A prática clínica baseada em evidências: parte III - avaliação crítica das informações de pesquisas clínicas. Rev Assoc Med Bras. 2004;50(2):221-8. [2019 Amazon Hot Selling 12ml Matte Black Empty Perfume Roller Bottle]
6. Jadad AR, Moore A, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan, et al. Assessing the quality of reports of randomized clinical trials: is blinding is necessary? Control Clin Trials. 1996;17 (1):1-12. [4cavity Water Milk Bottle Blow Mould Machine Pet Making Machinery Price]
7. Nobre MRC, Bernardo WM. Busca de evidências em fontes de informação científica. In: Prática clínica baseada em evidências. São Paulo: Elsevier; 2006. p. 43-57. [Skull E-Liquid Bottle with Strong Suction Nozzle Dropper Perfume Bottle]
8. Leonas KK.Stage and Show LED Protection Aluminum Flight Case. Am J Infect Control. 1998;26 (5):495-501. [50 Tph Gold Ore Crushing & Processing Machine]
9. Rodrigues E. Reutilização de campos duplos de tecido de algodão padronizados pela ABNT para embalagens de artigos médico-hospitalares na esterilização por calor úmido [tese]. São Paulo:Horizontal Island Freezer for Frozen Food, Universidade de São Paulo; 2000. [Premium Grade Export Best Price Organic Bulk Supply New Crop Hot Sale Pumpkin Kernel]
10. Morya GA. Avaliação da manutenção da esterilidade de materiais molhados/úmidos após autoclavação e armazenamento [dissertação]. São Paulo:Horizontal Island Freezer for Frozen Food, Universidade de São Paulo; 2005. [Silicone Rubber Electric Wire with Fiberglass Braided]
11. The Cochrane Collaboration.Fashionable Women Sports Wear Custom Fitness Yoga Wear' Handbook Glossary. Version 4.2.5 [text on the Internet]. Oxford; 2001. [cited 2007 ago. 20]. Available from:Wholesale School Bag Children′s Day Pack Shoulder Backpack[Automatic Disc Filter System with Three-Way Backwash Valve]