Microbial load of trocar gynecological laparoscopy and possible source of contamination and clinical significance

• Grant number: 10/15615-2
• Support Opportunities: Regular Research Grants
• Start date: September 01, 2011
• End date: August 31, 2013
• Field of knowledge: Health Sciences - Nursing - Medical-Surgical Nursing
• Principal Investigator: Maria Isabel Pedreira de Freitas
• Grantee: Maria Isabel Pedreira de Freitas
• Host Institution: Centro de Atenção Integral à Saúde da Mulher (CAISM). Hospital da Mulher Professor Doutor José Aristodemo Pinotti. Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil
• Associated researchers: Carlos Emilio Levy ; Vanessa Aparecida Vilas Boas

Abstract

The surgical site infections (SSI) in the case of minimally invasive surgery or outpatient services, such as laparoscopy and hysteroscopy may be underreported, requiring the study of the instruments used in those procedures with systematic monitoring of patients treated. Purpose: To relate the microbial load trocars used in laparoscopic surgery for gynecologic sources of contamination endogenous and exogenous, and to evaluate the clinical significance of the patient, comparing the microorganisms present in the trocar with the microbiota of the patient obtained from specimens collected by swabs, identifying signs and post-surgical symptoms, related to SSI, the hospital stay and post-discharge; evaluate the effectiveness of the sterilization process of the trocar performed in the autoclave bench per cycle fast. Methods: a cohort study with a quantitative approach, to be held in the operating room of a public teaching hospital, specializing in women's health within the state of Sao Paulo. The sample will be composed of 266 trocars, with 133 trocars 5 mm and 133 trocars 10 mm. Data collection will occur in three stages: 1) at admission, with collection of swabs as local access and communication of the surgical instrument: the navel, McBurney's point left and vaginal vault bottom. 2) In surgery, with collection of trocars in the operating room, and a pair of sterile trocars collected at the time of opening the box instrumental (control group), and a pair of trocars contaminated collected immediately after surgery. The trocars will be handled separately for the extraction of microbial load. The lumens of the trocars will be washed with injections of sterile distilled water, then removed the trocars will be placed in sterile plastic containers with 250 mL of sterile distilled water and agitated. The washed will be filtered in membrane 0.22 µm that will be placed on blood agar. The microbiological tests shall be performed using standard laboratory techniques. 3) In the post-discharge, with epidemiological surveillance for seven days after outpatient surgery and by telephone contact after 30 days, to assess the presence or absence of SSI. The data obtained will be worked through descriptive analysis. The McNemar test will be used to compare proportions of microorganisms found in the swabs and trocars with a significance level of 5%. Expected results: Brazil currently is mobilizing to set guidelines to ensure patient safety, the prevention of cross infection in clean surgeries and minimally invasive and low risk of complications, in other words, the customer service of health system with quality control. It is believed that this study may provide strategies for improving perioperative nursing care and infection control. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

VILAS-BOAS, VANESSA APARECIDA; LEVY, CARLOS EMILIO; PEDREIRA DE FREITAS, MARIA ISABEL; WOO, KEVIN. Microbial Load of Trocars: Potential Source of Contamination and Surgical Site Infection. SURGICAL TECHNOLOGY INTERNATIONAL-INTERNATIONAL DEVELOPMENTS IN SURGERY AND SURGICAL RESEARCH, v. 32, MAY 2018. (10/15615-2)