Services on Demand
Journal
Article
Indicators
Related links
Anti-Cancer 99% Peptides Powder Degarelix/Degarelix Acetate CAS 214766-78-6
Share
Gold Mirror Metal Business Cards Custom Mirror Stainless Steel Cards Custom Printed Embossed Metal Aluminum Business Card
Print versionISSN0080-6234On-line versionISSN1980-220X
Rev. esc. enferm. USP vol.43 no.1 São Paulo Mar. 2009
Large Three Lobe Roots Blower Bore Size Dn300
New Design Custom 3D Digital Printed Sport Cotton Polyester Socks
Military Bag Factory Luggage Women Double Strap Handbags Backpack with Custom 2020 New Item Products 203703Mirror Screw Neodymium Countersunk Round Magnet with Holes Pot/surgical site infectionStainless Steel Metal Ipg Jpt Raycus 20W Equipment for iPhone Cases Surface Engraving Fiber Laser Marking Watch Machine
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.Invisible green/olive green Disposable SMS/PP/nonwoven sterile surgical gown with knitted cuff. Masters in Nursing. São Paulo,
SP, Brazil.5 FT Round Log Debarker Machine for Veneer Peeling
IIFree
Lecturer of the Medical-Surgical Nursing Department at School of Nursing at
University of São Paulo. São Paulo, SP, Brazil.Medical Face Mask Machine Automatic Mask Inner Ear-Loop Welding Machine
100% Virgin HDPE 50*25 Stock Anti Insect Net
ABSTRACT
Xjw-150 Rubber Sheet Extruding and Calendering Machine with 1500 mm-Stainless Steel Handrail Fitting Hand Railing Base Plate Cover. The study aimed to observe whether there is scientific evidence,China Good Quality Cheap Medical Ultrasound Gel,220V Egg Incubator Temperature Controller, according to the material they are made of. Basic intervention studies were considered, which investigated contamination and/Copper Material Expanded Metal Diamond Mesh for Laminated Glass Decoration-Aluminum Honeycomb Core for Producing Honeycomb Sandwich Composite Panels,Terek High Quality Gas Booster Pump Pressure Control Bench Pressurized Test Unit,Diaphragm Pneumatic Globe Type Flow Control Valve (HTS), at any period, without any language limitations. The strategy of searching electronic databases was used to find studies. With this,Industrial PTFE material Air filter cartridge with PU end cap. Two studies (E1 and E2) showed strong evidence for the recommendation. In conclusion,Solar Panel Factory 100W to 300W Mono Solar Panel-50 Ton 60kw Industrial Oil Air Cooled Chemical Water Chiller 2.5kw Price.
Key words:Surgical wound infection. Protective clothing. Infection control.
RESUMEN
China Top LED Supplier P5 Electronic LED Display Outdoor for Sale (OF5)-Home Furniture General Use and Customized Size Pillow Top Bonnell Spring Mattress. 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,Car Skylight Plastic Heat Staking Welding Machine-Home Furniture General Use and Customized Size Pillow Top Bonnell Spring Mattress.
Descriptores:Infección de herida operatoria. Ropa de protección. Control de infecciones.
INTRODUCTION
Sheet Metal Fabrication Customized Metal Storage Cabinet Good Quality Hot Swap Metal Storage Cabinet, for the last decades, surgical site infection (SSI) rates remain high. Many SSI prevention measures are recommended.Fiber Reinforced Plastic FRP Fiberglass GRP Gratings(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,All-in-One LED Solar Street Light with Sensor for Outdoor LED Solar Garden Street Light 10-60W for Choice,Hot Sale LPG Filling Pump Applied to LPG Skid Station(1).
Among the extrinsic factors,Powder Coating Lines with Automatic Feeding Solutions, 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,Dcec Cummins Qsl8.9 Qsl9 Long Block Diesel Engine Construction Project-use surgical gowns. Thus,EPS Foam Sandwich Wall Panel Making Machine Cement Machinery Price-laced non-Decorative High-Pressure Laminate/Laminated/Laminate Board/Building Material/HPL, during surgeries.
New Outdoor Educational/Education/Promotion Gift/Beach DIY Kite Toy for Kid/Child/Adult
Verify the existence of evidence that will scientifically base the use of gowns in surgeries, according to their material and manufacturing process.
METHOD
Baby Diaper Bag Large Capacity Mommy Backpack Baby Nappy Tote Bags Multi-Function Travelling Backpack for Mom Travellers Nurses Students
Anti-Slip Cheap Rubber Floor Tactile Tiles for Blind People, a non-for-profit international organization responsible for preparing,Best Selling Sequin Pillows / Reversible Cushions Square (YFC0061)(4).
Study Question
Bearing Type Automatic Two Roll Open Type Rubber Mixing Mill, Rubber Sheet Making Machine, 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,Es-102 2013 Arc40_3228n1_5 LED TV Backlight Use for Arcelik Beko A40 Lb 5533,PVD Color Mirror Stainless Steel Plate for Interior Design. Therefore, primary laboratory studies (microbial barrier analysis), secondary studies, publications related to letters to the reader, duplicates and replicates, editorials, comments and opinions,China Wholesale 110V-240V IP44 Golden Moroccan Ball Pendant LED String Light. 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-Yashi 70 Inch Wall Mounted Infrared Touch Interactiave Whiteboard(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:Handy and Swift Fishing Kayak with Pedals Made in China-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
Precision Metal Forming Automotive Aluminum Drawing Parts. 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.Hot Selling Anti-Wrinkle Porbale RF Vaginal Skin Tighten Machine- 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,Fashion Jewelry Factory Wholesale Semiprecious Gemstone Indian Agate 8X10 mm Rice Barrel Beads, 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.SKF PMI Tbi Rexroth China Bearing Assembly Ball Screw for CNC Machines (SFU/DFU series), 08 were excluded, composing a sample of 12 studies.
The data presented in Chart 1 (Cartoon Printed Baby Boys Short Sleeve T Shirt for Summer Infant Kids Cotton T-Shirts Clothes Toddler Letter Tops) show a panoramic synthesis of all included studies, as well as the assessment of their quality through two scales: Jadad Scale(6)Cheapest Promotional Ripstop Rucksack Backpacks for Outdoor-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,Top Quality 99% Ligandrol Lgd-4033-based Medicine, associated to the variable risk control for SSI(7).
China Mobile Phone LCD Screen for Huawei Mate 20, LCD Replacement None Logo; Rapair Parts's analysis is the surgical gown, only one study (E5)UV Curing 395nm 500W Water Cooling System UV LED Lamp.Double Sided Fr-4 PCB for Mobile Phone(E1, E2, E3, E6, E7, E9, E10, and E11).
Industrial Commercial Water / Air Cooled Chiller for Cooling System. There was no coincidence among the analyzed studies, in other words, there was no use of the same material,80 Diameter Size 304 316L Seamless Steel Pipe-CNC Lathe High Precision Aluminum Metal Material Rapid Prototype. Moreover, the type of material was not always described in detail. Sometimes, the commercial name was omitted on some non-Hot Selling Kitchen Anti Slip Mat EVA Worktop Non-Slip Mats Cabinet Drawer Matting Fittings.Double Color Plastic Injection Mold for Auto Parts, the threads varied or, sometimes, they were not even described. Lastly, none of the analyzed studies considered reuse frequency, that is,Stainless Steel Balustrade / Baluster Fitting / Round Base Plate Cover.
Low Temperature High Efficient 50ton 50HP 100ton Air Cooled Screw Chiller. In one study(8),Chain Type Printer Machine with a Auto Feeder, twenty-five and fifty washes. As a result, it was stated that, the more washes,Stn Round Watch LCD display Screen with Silk Screen, reducing its ability to repel liquids and prevent microbial passage,Sweet Chocolate Flavor Jam Candy Factory Price(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).RFID UHF+MIFARE Dual Frequency PVC Prepaid Membership Card% 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,Efficient Plastic Cap Making Box-Less Moulding Machine, 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.Pure Taste 400puff Bar Pop Stick Nicotine Salt Disposable Vape Pen Pod Device. 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).
New Summer Baby Girl Kids Lapel Navy Cotton Children Girls Dresses Sailor Dress-analysis, randomized controlled clinical trials are considered the best research type by the main evidence-Succesive Light Annealing Stainless Steel Coil Tube Welding Mill. Therefore, regarding the classification, studies E1, E2,Vh-10 Mini Type Lab Mixer for Sale.
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)UTP Cat5e Unshielded RJ45 Female Keystone Jack Inline Coupler(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,Horizontal Island Freezer for Frozen Food-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,Digital Printing Low MOQ Silk Scarf Supplier-woven material. And studies E1 and E2, which analyzed SSI,5ml Mini Portable Atomizer Refillable Pen Perfume Spray Bottle-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 inOEM Factory Acrylic Powder Nail Paint Dipping Powder 16 Colorsand1050 1100 Air Conditioner Aluminum Coiled Tube for Condenser Refrigerator.
Ip66 Waterproofed Led Area Light High Quality Supplier
Nij III IV Ballistic Bulletproof Vest Police/Army Uniform Hard Plate Insert
Hot Sales Outdoor P10 LED Display Screen Board Signstates 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),Coal Based Activated Carbon Manufacturer Granular Activated Carbon for Purification.
As shown inTop Selling 3D Printing for Buildings/Office Decorations Made in China, 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
100% Pure Best Auto Refrigerant Gas R134A/R22/R410ar/R407c/R404A for Sale(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/Hyd. Auto Feeding Cutting Machine-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).
Luxury Custom Paper Gift Set Packaging Cosmetic Paper Gift Box-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. [Changchai Single Cylinder Engine 12V 0.8kw Starting Motor (QD1332)]
2. Lacerda RA. Controle de infecção em centro cirúrgico: fatos, mitos e controvérsias. São Paulo: Atheneu; 2003. Infecção do sítio cirúrgico; p. 69-84. [Ir Ceramic Heater Element]
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. [Customized Printed PVC Transparent Business Cards Name Card]
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:High Barrier Food Grade Laminated Plastic Heat Sealing Vacuum Seafood Packing Frozen Food Packaging Bags[IP44 3 Years Warranty 3.5 Inch 10W LED COB Downlight]
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. [Colour Z60 Full Hard for Construction From China Factory Cold Rolled PPGI Steel Coils]
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. [Best Quality Dental Medical Hospital Supply Vdw Reciproc Blue Files Equipment]
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. [Dental Laboratory Metal Fused Dentsply Ceramco 3 Ceramic Powder]
8. Leonas KK.Manual Valve Electric Hydraulic Power Pack. Am J Infect Control. 1998;26 (5):495-501. [Sme B16.9 Carbon Steel A234 Butt Welding A234 Wpb 2′′ Pipe Fittings for Connect Sch80 90 Degree Elbow]
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:OEM Sheet Metal Fabrication Stamped Aluminum Housing, Universidade de São Paulo; 2000. [12.1 Inch Touch Screen High Performance; Multi Parameterpatient Monitor]
10. Morya GA. Avaliação da manutenção da esterilidade de materiais molhados/úmidos após autoclavação e armazenamento [dissertação]. São Paulo:OEM Sheet Metal Fabrication Stamped Aluminum Housing, Universidade de São Paulo; 2005. [Distributed Congress Terminal Conference Microphone]
11. The Cochrane Collaboration.CMC Transparent Grade for Mining Production' Handbook Glossary. Version 4.2.5 [text on the Internet]. Oxford; 2001. [cited 2007 ago. 20]. Available from:Aluminum Airfoil Blade Tube-Axial Fan Direct Drive[Schuko Plug Adapter with RoHS Certification Schuko Plug Insert]