Reis SB, Portugal M, Tavares M
… +3 more, Adan M, Santana G, Romeo A
Rev Col Bras Cir
· 2026 · PMID 42138870
·
Full text
INTRODUCTION: The Revised Trauma Score (RTS) is one of the primary tools used to predict mortality in trauma patients. RTS is calculated at admission based on respiratory rate, systolic blood pressure, and Glasgow Coma S...INTRODUCTION: The Revised Trauma Score (RTS) is one of the primary tools used to predict mortality in trauma patients. RTS is calculated at admission based on respiratory rate, systolic blood pressure, and Glasgow Coma Scale score. Its accuracy has been evaluated in several studies; however, most have predominantly included victims of blunt trauma, making its applicability to penetrating injuries a matter of ongoing debate. OBJECTIVE: To compare the prognostic accuracy of the RTS for mortality prediction in patients with blunt trauma versus penetrating trauma. METHODS: This retrospective cohort study included trauma patients treated at a referral hospital. The prognostic accuracy of the RTS for each trauma mechanism was assessed using receiver operating characteristic curves, and comparisons were performed using the DeLong test. Logistic regression analysis was conducted to identify additional independent predictors of trauma mortality. The chi-square test was used to determine a cutoff point for the RTS in penetrating trauma that would correspond to the reference cutoff adopted for blunt trauma. RESULTS: A total of 3,575 patients were included. Of these, 2,448 (68.5%) sustained blunt trauma and 1,127 (31.5%) penetrating trauma. The area under the curve for mortality prediction was 0.813 in the blunt trauma group and 0.800 in the penetrating trauma group, with no statistically significant difference between them. Independent predictors of mortality included age, RTS value, acidosis, coagulopathy, and penetrating mechanism. CONCLUSION: The RTS is an accurate tool for predicting mortality in both blunt trauma and penetrating trauma.
Silva BDPD, Evangelista Neto E, Perfeito JAJ
… +1 more, Miotto A
Rev Col Bras Cir
· 2026 · PMID 42138868
·
Full text
INTRODUCTION: Artificial intelligence (AI) is playing an increasingly significant role in medicine, from imaging-based diagnosis to personalized treatment. In the postoperative period, it may enhance patient support by a...INTRODUCTION: Artificial intelligence (AI) is playing an increasingly significant role in medicine, from imaging-based diagnosis to personalized treatment. In the postoperative period, it may enhance patient support by answering questions more clearly and reducing the need for in-person visits. However, its reliability and effects on the patient experience remain insufficiently studied. This study examined the potential of AI as a complementary tool in the care of patients undergoing thoracic surgery, assessing response accuracy, patient acceptance, and its potential to reshape postoperative follow-up. METHODS: Real patient questions were collected and answered by both ChatGPT and specialist physicians. The responses were compared in terms of clarity, accuracy, and completeness. Participants evaluated their satisfaction with the information provided, their need to seek additional details, and their comfort level with using AI without medical supervision. RESULTS: Among the patients evaluated, 74.3% reported that ChatGPT fully addressed their questions, and 91.4% found the language clear and accessible. However, 62.8% still indicated a need for medical confirmation. In addition, 51.4% of participants stated that they would seek additional information even after receiving an AI-generated response. CONCLUSION: The findings suggest that AI has strong potential to enhance patients' postoperative experience by providing rapid, accessible answers. However, its use should be integrated into a hybrid care model that combines technology with individualized medical oversight.
Volpon LC, Araujo CM, Souza AP
… +3 more, Aragon DC, Scarpelini S, Carlotti APCP
Rev Col Bras Cir
· 2026 · PMID 41983893
·
Full text
INTRODUCTION: To investigate the clinical characteristics and risk factors associated with interventional treatment in critically ill pediatric patients with Intra-abdominal Trauma (IAT). METHODS: This was a retrospectiv...INTRODUCTION: To investigate the clinical characteristics and risk factors associated with interventional treatment in critically ill pediatric patients with Intra-abdominal Trauma (IAT). METHODS: This was a retrospective cohort study of patients younger than 18 years with IAT admitted to a Pediatric Intensive Care Unit (PICU) at a Brazilian emergency hospital between January 2015 and January 2024. Patients with hollow viscus injury were excluded. Demographic, clinical, treatment, and outcome data were collected from medical records. Patients were divided into two groups according to management strategy: interventional or conservative. RESULTS: During the study period, 41 patients with IAT were admitted to the PICU; 35 were included in the study. Most patients were male (77.1%), with a median age of 9.6 years (range, 0.7-17 years), and more than half had Injury Severity Score (ISS) values greater than 25. Motor vehicle collisions were the most common mechanism of injury (68.6%). The most frequently injured organs were the liver (57.1%) and spleen (40%). Fifteen patients (42.9%) underwent interventional management: 11 (73.3%) surgical intervention and 4 (26.6%) interventional radiology. Hypotension on admission and the need for massive transfusion were identified as risk factors for interventional treatment. Two patients (5.7%) died; both underwent damage control laparotomy. CONCLUSIONS: In this cohort of critically ill pediatric patients with solid organ IAT, 42.8% required interventional management. Hypotension on admission and the need for massive transfusion were risk factors for interventional management in this population.
Doll D, Sachoczewski COV, Heitmann H
… +3 more, Hackmann T, Ankersen JL, Haas S
Rev Col Bras Cir
· 2026 · PMID 41810655
·
Full text
INTRODUCTION: Wound healing problems are common after Pilonidal Sinus Disease (PSD) surgery and may come misclassified as recurrence during the first 6-12 postop. month. We hypothesized that misclassification of post-ope...INTRODUCTION: Wound healing problems are common after Pilonidal Sinus Disease (PSD) surgery and may come misclassified as recurrence during the first 6-12 postop. month. We hypothesized that misclassification of post-operative wound complications as recurrence would be reflected when comparing early and late annual recurrence rates. METHODS: The postop. recurrence rate was analyzed in 1,254 studies encompassing 2,030 study treatment groups (n=140,472 patients), follow-up-studies <1year (n=304 studies) versus studies with longer FUP (n=950 studies). Recurrence rate was calculated for groups and subanalysis done for therapeutic strategies in this observational study. RESULTS: First-year recurrence rate (RR) was markedly higher in the studies with <1-year follow-up compared to studies with ≥1-year follow-up (median RR 6.0%/year vs. 2.0%/year, RD=4.0%). Examining individual therapies' recurrences after primary open treatment saw 8%/year versus 2.5%/year (RD=5.5%) RR, for primary midline closure 20%/year vs. 3.2%/year (RD=16.8%) and Pit Picking 20.7%/year vs. 4.0%/year (RD=16.7%). CONCLUSION: The one-year RR is containing a respectable portion of misclassifications (untrue recurrences) that may exceed the true recurrence rate by a factor of 3-5. If reliable recurrence rate needs to be determined, follow ups of <one year should be avoided. Studies of n=200 participants and larger exhibit a smaller chance of recurrence rate error and should be aimed for if possible. What does this paper add to the literature? This is the first work to quantify the amount of misclassification of "recurrences" within the first year following PSD surgery.
Kulcheski ÁL, Milcent PAA, Graells XSI
… +3 more, Scalabrin JGB, Nunes CP, Stieven Filho E
Rev Col Bras Cir
· 2026 · PMID 41810654
·
Full text
INTRODUCTION: Surgical simulators offer substantial benefits for technical skills training by providing a risk-free environment for practice. However, access to effective simulators in surgical education remains limited....INTRODUCTION: Surgical simulators offer substantial benefits for technical skills training by providing a risk-free environment for practice. However, access to effective simulators in surgical education remains limited. This study aimed to validate a synthetic lumbar spinal endoscopy simulator through skills transfer and assess its educational applicability. METHODS: Forty medical students were randomized to simulator training (n=20) or control (n=20). After training, all performed supervised diagnostic endoscopy. Procedures were recorded and evaluated by a blinded examiner for total time, look-downs, instrument loss, supervisor interventions, and Global Operative Assessment of Laparoscopic Skills (GOALS). A Likert-scale questionnaire assessed perceptions of simulation training. RESULTS: The intervention group showed superior performance, with reductions of 43.7% in procedure time, 85.3% in look-downs, 75.9% in interventions, 93.3% in instrument loss duration, and 91.2% in total loss percentage (p<0.001). GOALS scores were significantly higher in all domains (p<0.001). All participants endorsed incorporating simulation into medical education. CONCLUSION: The simulator demonstrated strong transfer validity, significantly improving surgical performance. GOALS scores tripled among simulator-trained participants, and acceptance of the simulator for educational use was unanimous..
Santos MEDRD, Cella MA, Martin ASS
… +3 more, Canton KM, Ambros LE, Marcante Carlotto JR
Rev Col Bras Cir
· 2026 · PMID 41711817
·
Full text
INTRODUCTION: Growing technological innovation represents an advance in medical decision-making. However, the large number of computed tomography (CT) scans performed in the emergency department is worrying due to the co...INTRODUCTION: Growing technological innovation represents an advance in medical decision-making. However, the large number of computed tomography (CT) scans performed in the emergency department is worrying due to the costs generated by the hospital and the exposure of patients to ionizing radiation. The availability and performance of the exam, however, does not necessarily mean an increase in diagnoses, and some of these exams may not show any pathology or alteration. Thus, our study aims to evaluate the accuracy between the emergency physician's diagnostic hypothesis and the results of the requested tomography of the skull, thorax and abdomen segments. METHODOLOGY: Prospective cross-sectional study between September 2023 and February 2024. The sample consisted of 331 patients, the inclusion criteria being: majority, having undergone a tomographic examination of the skull, chest or abdomen and having signed the Free and Informed Consent Form (ICF).). Statistical analysis was performed using IBM SPSS Statistics 27.0 software. RESULTS: 409 CT scans were analyzed, of the CT scans performed, 49.74% were devoid of acute findings. Proportion of agreement with the initial clinical diagnostic hypothesis was 39.5% in the skull, 40.3% in the abdomen and 43.7% in the thorax. CONCLUSION: This study identified low agreement between clinical hypotheses formulated in the emergency room of a tertiary hospital and acute tomographic findings, highlighting situations in which the use of CT was considered unnecessary for formulating the final diagnosis. However, it is pertinent to highlight the limitations of the study, above all, the impossibility of directly evaluating the reasons why each exam was requested within the subjective nuances of clinical practice.
Rev Col Bras Cir
· 2026 · PMID 41711816
·
Full text
INTRODUCTION: Pilonidal disease (PD) is a chronic inflammatory disorder affecting the skin and subcutaneous tissues of the sacrococcygeal region, with a predominant impact on young adults. Although there have been consid...INTRODUCTION: Pilonidal disease (PD) is a chronic inflammatory disorder affecting the skin and subcutaneous tissues of the sacrococcygeal region, with a predominant impact on young adults. Although there have been considerable advances in surgical management, national-level epidemiological data on PD in Brazil remain scarce. METHODS: We conducted a retrospective, descriptive, population-based study analyzing all surgical procedures for PD recorded in Brazil's public health system (SUS) from January 2014 to December 2023. Data were extracted from the DATASUS platform, using specific procedural codes for pilonidal sinus. Prevalence rates per 100,000 inhabitants were calculated utilizing population estimates from the Brazilian Institute of Geography and Statistics (IBGE). Temporal trends were assessed through linear regression analysis, and regional comparisons were performed using Pearson's chi-square test with Bonferroni correction. RESULTS: Throughout the ten-year period, 45,915 patients underwent surgery for PD, yielding a mean prevalence of 2.42 cases per 100,000 inhabitants. The highest regional prevalence was observed in the South, while the North had the lowest rates. An overall upward trend in surgical intervention rates was noted, particularly from 2014 to 2019, with a temporary decline during the COVID-19 pandemic (2020-2021) and subsequent recovery. Significant regional disparities were evident, suggesting that healthcare infrastructure and access differences may contribute to these patterns. CONCLUSION: Pilonidal sinus disease (PSD) has shown a steady rise in surgical cases in Brazil, particularly in the South and Southeast regions. Despite lower national prevalence compared to high-income countries, the increasing trend highlights growing public health concerns and significant regional disparities.
Sasaki VL, Coelho JCU, Wiederkehr HA
… +6 more, Costa MARD, Andrade D, Sanches JPB, Wiederkehr JC, Ramos EB, Pissaia Junior A
Rev Col Bras Cir
· 2026 · PMID 41711815
·
Full text
RATIONALE: Hepatic Artery Thrombosis (HAT) is the most common and severe vascular complication in patients undergoing Liver Transplantation (LT), with an incidence ranging from 2% to 9% and mortality between 11% and 60%....RATIONALE: Hepatic Artery Thrombosis (HAT) is the most common and severe vascular complication in patients undergoing Liver Transplantation (LT), with an incidence ranging from 2% to 9% and mortality between 11% and 60%. Despite its clinical relevance, Brazilian publications on the topic remain limited. OBJECTIVES: To evaluate the diagnosis, treatment, and outcomes of HAT in patients undergoing LT at three Brazilian hospitals (Hospital Santa Isabel, Blumenau, Santa Catarina; Hospital das Clínicas, Curitiba, Paraná; and Hospital Nossa Senhora das Graças, Curitiba, Paraná). METHODS: This was a longitudinal, observational, retrospective study including patients diagnosed with HAT after LT between September 1991 and December 2023 at three major Brazilian medical centers. Data were obtained from electronic medical records and institutional protocols. RESULTS: Among 1,362 transplants performed, 35 patients developed HAT, corresponding to an incidence of 2.6%. Doppler ultrasound detected the condition within the first 48 hours in 43.8% of cases. Intraoperative assessment of arterial pulse alone was not associated with mortality (p = 0.16). Patients who underwent retransplantation showed a trend toward lower mortality (p = 0.076). CONCLUSION: Retransplantation is associated with reduced mortality in HAT cases and is considered the gold-standard treatment. Intraoperative Doppler ultrasound should be considered not only as a screening tool but also as an aid in surgical decision-making.
Rev Col Bras Cir
· 2026 · PMID 41615166
·
Full text
INTRODUCTION: Surgical site infection (SSI) and polypropylene mesh (PPM) infections are recurrent problems in abdominal hernia surgeries, highlighting the need for a new antimicrobial material for surgical repair. The ai...INTRODUCTION: Surgical site infection (SSI) and polypropylene mesh (PPM) infections are recurrent problems in abdominal hernia surgeries, highlighting the need for a new antimicrobial material for surgical repair. The aim of this study was to evaluate the in vivo antimicrobial effect of a new biological mesh made of decellularized bovine pericardium (BP), added with vancomycin (VAN) or silver nanoparticles (AgNPs), as prevention for SSI. METHODS: Thirty-five Wistar rats were divided into four groups: BP C+ (n=9) with BP without additions; PP C+ (n=8) with PPM; BP AgNPs (n=9) with BP added with silver nanoparticles; and BP VAN (n=9) with BP added with vancomycin. The 1 cm² meshes were stitched into the muscle fascia under the subcutaneous tissue of the rats' backs, followed by inoculation with methicillin-resistant Staphylococcus aureus. The animals were observed for 7 days, with subsequent euthanasia, and histological and bacteriological analysis. RESULTS: The BP VAN group had better infection control compared to the PP C+ and BP AgNPs groups (1x10¹ vs. 1.4x10³CFU/g, p=0.0303; 1x10¹ vs. 1.5x104CFU/g, p<0.0001, respectively). BP AgNPs showed less bacterial reduction compared to BP C+ (p=0.042). In the histological analysis, there was a mild inflammatory reaction in BP VAN, moderate in BP C+, and intense in PP C+ and BP AgNPs. CONCLUSION: BP added with vancomycin showed promising antimicrobial action, while the use of silver nanoparticles did not demonstrate efficacy in this study.
Barreira CESR, Dias FL, Farias TP
… +37 more, Kowalski LP, Santos IC, Vartanian JG, Beltrão AF, Mendonça UBT, França BS, Chone C, Priante AVM, Silva GS, Bilhar PF, Pedruzzi PAG, Cicco R, Santos SR, Carlucci Junior D, Viana AOR, Vanni CMRS, Quintanilha MA, Fonte Neto A, Rocha RM, Miranda AP, Cavassani M, Nakamura E, Capuzzo R, Neves MCD, Maia Filho P, Fernandes KL, Castro MA, Nakai MY, Matos LLM, Hojaij FC, Capelli F, Melo GM, Noleto L, Castro Neto HFE, Matos FCM, Oliveira AF, Pinheiro RN
Rev Col Bras Cir
· 2026 · PMID 41615164
·
Full text
The Brazilian Society of Surgical Oncology and the Brazilian Society of Head and Neck Surgery developed a technical consensus on hierarchical coding in thyroid surgery, considering the role of the Brazilian Hierarchical...The Brazilian Society of Surgical Oncology and the Brazilian Society of Head and Neck Surgery developed a technical consensus on hierarchical coding in thyroid surgery, considering the role of the Brazilian Hierarchical Classification of Medical Procedures in determining appropriate codes. A panel of 40 specialists - recognized academic and clinical leaders from across Brazil - assessed the applicability of procedure codes for common thyroid surgeries and prepared the current consensus. Deliberations were conducted via electronic voting among 37 participants, and consensus was defined as agreement by at least 80%. Scenarios included total thyroidectomy for benign and malignant disease and resection of substernal goiter. The analysis covered codes for laryngeal nerve exploration, neurophysiological monitoring, carotid artery branch ligation, biopsy, parathyroid reimplantation, lymphadenectomy, and neck dissection. Consensus supported the use of the following codes: nerve exploration (83.3%), neurophysiological monitoring (97.3%), biopsy and parathyroid reimplantation (89.2%), cervical lymphadenectomy (89.2%), and unilateral or bilateral neck dissections (97.3% and 94.6%, respectively). No consensus was reached on including carotid artery branch ligation or adding a partial thyroidectomy code for unilateral substernal goiter; therefore, these codes were not validated. The current consensus provides clear, objective guidance on hierarchical coding for thyroid surgery based on technical, scientific, and ethical criteria. It is intended to support attending physicians and auditors by promoting consistency, transparency, and reduced conflict in clinical and administrative settings.
Santos PHSCD, Galafassi RZ, Lopes GFMR
… +4 more, Guimarães LAA, Bobadilla FRH, Nishimoto IN, Dedivitis RA
Rev Col Bras Cir
· 2026 · PMID 41538565
·
Full text
INTRODUCTION: Thyroidectomy, which consists of partial or total removal of the thyroid gland, is a commonly performed surgery to treat various thyroid diseases. In recent years, the trend has been toward partial thyroide...INTRODUCTION: Thyroidectomy, which consists of partial or total removal of the thyroid gland, is a commonly performed surgery to treat various thyroid diseases. In recent years, the trend has been toward partial thyroidectomies, due to their association with lower complication rates and the fact that they may be sufficient for adequate management. OBJECTIVE: To evaluate the impact of partial and total thyroidectomy on quality of life. METHODS: This study used the ThyPro questionnaire, which assesses the quality of life of patients with thyroid disorders, to investigate the impact of different thyroidectomy approaches on patients' quality of life. RESULTS: The postoperative complications were transient unilateral recurrent nerve paralysis (6.5%) and transitory hypoparathyroidism (22.4%). The quality of life outcomes after thyroidectomy were favorable. The extension of the thyroidectomy did not present statistical difference (p = 0.982). Significantly lower scores were associated with female gender and neck dissection. CONCLUSION: Quality of life scores were high, with lower scores among women and neck dissection.
Rev Col Bras Cir
· 2026 · PMID 41538564
·
Full text
INTRODUCTION: biofilm is considered a challenge regarding treatment of chronic diseases and, after a detailed observation of cleaning and sterilization processes, it is considered could be a threat to sterility of surgic...INTRODUCTION: biofilm is considered a challenge regarding treatment of chronic diseases and, after a detailed observation of cleaning and sterilization processes, it is considered could be a threat to sterility of surgical instruments that are "ready to use". Colored plastic bands (color coding tapes for marking surgical instruments) are frequently used to assist in the assembly of surgical instrument boxes. These bands form a lifting, which makes cleaning the material difficult. Epidemiological data regarding the frequency of surgical site infection in Brazil (up to 24% in Center-West Region) may be suggestive of contamination of operative instruments. The objective of this study is to answer the question: is there a risk of biofilm on ready-to-use surgical instruments? METHODS: narrative literature review. RESULTS: 296 articles were found and a total of 163 were selected for detailed reading, of which 78 were included. During the survey, four knowledge domains were outlined: microbiology, pathophysiology/epidemiology, technology and management. This review pointed out the risk of the bacterial load prior to autoclaving, the efficiency of the sterilization method regarding the presence of microscopic soils and, under current conditions, the ability of the Material and Sterilization Centers to ensure adequate cleaning. CONCLUSION: after working extensively to associate all the collected information, there is a considerable probability of bacterial biofilms in ready-to-use surgical instruments and, therefore further research in this field of microbiology is justified, with an emphasis on improving process quality indicators, giving the potential impact on reduction of surgical site infection rates.
Morrell ALG, Morrell AG, Morrell Junior AC
… +1 more, Morrell AC
Rev Col Bras Cir
· 2026 · PMID 41538563
·
Full text
INTRODUCTION: diastasis recti surgery has been known worldwide for open surgical techniques involving significant tissue manipulation, skin flap and larger incisions. Traditional methods typically required extended recov...INTRODUCTION: diastasis recti surgery has been known worldwide for open surgical techniques involving significant tissue manipulation, skin flap and larger incisions. Traditional methods typically required extended recovery times and posed higher risks of complications and scarring issues. The advent of robotic-assisted surgery has revolutionized the treatment paradigm for abdominal wall defects and its remarkable outcomes encouraged expanding its applications towards diastasis recti pathologies. Better visualization and more ergonomic instruments foster a minimal scarring procedure, allowing surgeons to improve aesthetic and recovery outcomes following diastasis recti correction in a posterior approach. This article describes a robotic surgical technique and results to an unprecedented approach, putting its form of treatment into another perspective. TECHNICAL REPORT: a step-by-step guided technique of this novel technique is described using detailed port placement and figures to assure optimal aesthetic and functional outcomes whenever acting in minimally invasive diastasis recti repair with the da Vinci platform. CONCLUSION: The described technique reveals a hidden minimal incisions procedure avoiding skin flaps, scarring issues, and minimizing wound morbidity. Through a step-by-step guide, this report establishes an unprecedent technique description transforming the diastasis recti surgery scenario and its aesthetic outcomes with a safe minimally invasive surgery.
Rev Col Bras Cir
· 2026 · PMID 41538562
·
Full text
INTRODUCTION: Robotic surgery has been used in the treatment of various surgical diseases due to its precision and satisfactory outcomes. This study aims to describe the profile of patients undergoing robotic surgery at...INTRODUCTION: Robotic surgery has been used in the treatment of various surgical diseases due to its precision and satisfactory outcomes. This study aims to describe the profile of patients undergoing robotic surgery at the Hospital de Clínicas de Passo Fundo and analyze the variables related to the procedure and its outcomes. METHODS: A total of 215 medical records of patients who underwent robotic surgery at the Regional Robotic Surgery Center of the Hospital de Clínicas de Passo Fundo were reviewed, from the start of the program in 2023 until March 2024. Sex, age, comorbidities, and perioperative and postoperative data were evaluated. RESULTS: The sample had a predominance of males (73.5%). The average age was 61 years. Systemic arterial hypertension was the most prevalent comorbidity (43.7%). Regarding operative time, the first six months had a higher median total time (300 minutes) compared to the last six months (245 minutes) with p≤0.001. CONCLUSION: The implementation of a robotic surgery center in the interior of Brazil proved to be feasible, with favorable outcomes, progressive reductions in surgical times, and regional benefits by expanding access to cutting-edge technologies.
Rev Col Bras Cir
· 2026 · PMID 41538561
·
Full text
INTRODUCTION: With the increase in healthcare spending, efficient resource management in surgical hospitals has become essential, especially with regard to managing patient flow to avoid delays. Therefore, tools that can...INTRODUCTION: With the increase in healthcare spending, efficient resource management in surgical hospitals has become essential, especially with regard to managing patient flow to avoid delays. Therefore, tools that can provide instant visibility of the patients location in each sector can be of great value in choices about resource allocation. Therefore, the objective of this study was to evaluate the applicability of indoor location technology in a hospital environment. METHODS: Prospective study, carried out from February to March 2024, in a private surgical hospital, with tertiary structure, specialized in the care of elderly patients. The records of the path of each elective patient were mapped from their arrival to the moment of their discharge, as well as the activities of the professionals involved, through an indoor Bluetooth location device. RESULTS: 320 patients were analyzed, with an average stay time in the reception of 25 minutes and the time in the preoperative preparation unit of 107 minutes. Urology, mastology, and oncology surgeries represented 50% of the case series. The median transport time for these patients was 19 minutes. Reception (75.6%) and nursing admission (72.5%) were the sectors with the highest percentage of correct execution. The delay rate was 89.9% in the first time slot, and in subsequent times the delay was significantly lower (70.1%) compared to the time scheduled on the map. CONCLUSION: Indoor location technology has applicability when used in the intra-hospital environment in the management of surgical patients, facilitating the identification of bottlenecks and their causes.
Rev Col Bras Cir
· 2025 · PMID 41417348
·
Full text
INTRODUCTION: Shorter fasting periods before and after surgery have been associated with better postoperative recovery and lower morbidity and mortality. However, it is not always possible to achieve current recommendati...INTRODUCTION: Shorter fasting periods before and after surgery have been associated with better postoperative recovery and lower morbidity and mortality. However, it is not always possible to achieve current recommendations in pediatric practice. Therefore, it is essential to study fasting time and its associated factors to implement better care strategies. METHODS: Cohort of 284 pediatric patients admitted for surgery between 2020-2021, Hospital São Paulo, Brazil. Data was collected through interviews and medical records. Simple and multiple linear models and logistic regression models were adjusted to study the associations. RESULTS: All preoperative patients fasted for a prolonged period and most resumed feeding 6 hours after the end of anesthesia. Preoperative fasting time was shorter for elective surgery than for urgent surgery (p=0.025). Factors associated with a longer preoperative fasting time (minutes) were: older age in years (ß=10; 95% CI=5.2-14.8) and history of previous surgery (ß=76.6; 95% CI=28.0-125.1). Factors associated with postoperative fasting time longer than 6 hours were: no immediate postoperative care in the surgical ward (OR=6.05; 95%CI=2.25-16.22), presence of complications during surgery (OR=3. 53; 95%CI=1.19-10.47), major operation size (OR=3.85; 95%CI=1.49-9.93), abdominal surgery (OR=36.52; 95%CI=13.48-98.91) and vomiting in the first 24 hours (OR=3.44; 95%CI=1.54-7.69). CONCLUSION: There are potentially modifiable factors associated with longer fasting times. Education and organization of the healthcare team regarding patient characteristics, care dynamics, and clinical complications may contribute to greater optimization of fasting times in pediatric surgical patients.
Mourão M, Baeninger M, Antonelli TS
… +3 more, Escudero DVDS, Almeida MCS, Gragnani A
Rev Col Bras Cir
· 2025 · PMID 41417347
·
Full text
INTRODUCTION: Severe burns significantly weaken the immune system and disrupt the skin's natural barrier, which increases the likelihood of healthcare-associated infections (HAIs) and raises the risk of mortality. METHOD...INTRODUCTION: Severe burns significantly weaken the immune system and disrupt the skin's natural barrier, which increases the likelihood of healthcare-associated infections (HAIs) and raises the risk of mortality. METHODS: Based on CDC criteria, this study retrospectively examines the incidence of HAIs in burn patients hospitalized at a university hospital in São Paulo, Brazil, over five years from 2018 to 2022. RESULTS: 536 patients were treated during this time, with 130 HAIs recorded in 88 individuals. The average age of the patients was 41 years, and the mean total body surface area (TBSA) affected by burns was 20.4%. The primary causes of burns were flammable liquids (39.7%), electrical injuries (25%), and scalds from heated liquids (14.8%). Burn wound infections were the most frequent HAI (51.5%), followed by bloodstream infections (13.8%), urinary tract infections (13.1%), and ventilator-associated pneumonia (10.7%). Regarding microbiological findings, 141 microorganisms were isolated, with gram-negative bacteria making up 71.6% of the total, gram-positive bacteria accounting for 21.2%, and fungi representing 7.1%. In three cases, no microorganism was identified. The mortality rate among these patients was 13,6%. CONCLUSION: Notably, the predominance of gram-negative bacteria in this population, responsible for more than 70% of infections, contrasts with findings from other studies. The findings highlight the importance of infection control to reduce morbidity and mortality in this vulnerable population.