Factors associated with complex surgical wounds in breast and abdomen: a case-control observational study.
Josimare Aparecida Otoni Spira, Eline Lima Borges, Patrícia Aparecida Barbosa Silva and 3 others
PMID 30328975WHAT IT FOUND
After breast or abdominal surgery, radiotherapy, hysterectomy, hernioplasty, laparotomy, hypertension, low schooling, age 18-59 years and fasting glucose ≤ 99mg/dL were linked to complex wounds.
Quadrantectomy was linked to fewer complex wounds.
Key findings
01After adjustment, radiotherapy, hysterectomy, schooling < 8 years, hernioplasty, laparotomy, age 18-59 years, fasting glycemia ≤ 99mg/dL and arterial hypertension were associated with a greater chance of complex surgical wound.
02Quadrantectomy remained associated with a lower chance of occurrence of complex surgical wound in the multivariate analysis.
03The study compared 160 patients with complex surgical wounds and 167 patients with simple surgical wounds among 327 patients.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The data came from one tertiary hospital that is a referral centre for complex wounds, so the findings may not apply to other settings. Information was taken from medical records after the fact, so missing or inaccurate entries were possible. The study could not identify the cause of each surgical wound complication, such as hematoma, infection or dehiscence. Only patients who had access to surgery were included, so people who never received treatment were not represented. Neoplasia was not included in the multivariate model because it overlapped with radiotherapy. For exeresis and cesarean section the odds ratio could not be calculated because there were null cases.
The easy way to misread this
Do not read the large adjusted odds ratios as proof that radiotherapy or a particular operation caused the complex wound. The study compared records of patients who already had complex wounds with those who did not, and the authors could not identify the cause of each complication.