A atual caracterização de infecção do sítio cirúrgico em incisional superficial, incisional profunda e órgão cavidade, em substituição à tradicional definição de "infecção de ferida operatória", associada a estratificação dos pacientes em grupos de risco de infecção cirúrgica de acordo com a metodologia NNISS (National Nosocomial Infection Surveillance System), permitiram a obtenção de taxas de infecção mais fidedignas e estudos comparativos entre instituições diferentes. Baseado nessa metodologia, o presente trabalho analisa prospectivamente 2.149 pacientes operados no Serviço de Cirurgia do Hospital Geral César Cals (HGCC)-CE, estratificados pelo IRIC (Índice de Risco de Infecção Cirúrgica) e comprova diferenças estatisticamente significativas nas taxas de infecção de sítio cirúrgico para os grupos de IRIC 0, 1,2 e 3, respectivamente de 3,2%, 7,4%, 16,6% e 20,9%. As infecções de maior gravidade ocorrem em pacientes com IRIC 3 e a vigilância pós-alta é importante, na medida em que muitas infecções somente serão diagnosticadas após a alta hospitalar.
Patients undergoing surgery are at risk of surgical site infection-SSI. According to data from the National Nosocomial Infection Surveillance System-NNISS, in the United States surgical infections are the second most common type of nosocomial infection. The aim of this study is to assess surgical-site infection rates for patients operated in a general hospital in Northeasteen Brazil, break them down according to the Surgical Infection Risk Index-SIRI, and then classify such infections according to their gravity. A prospective evaluation was conducted of 2,149 surgical patients between January 1996 and January 1998, at the Cesar Cals General Hospital, using the methodology of the NNISS, adapted to our hospital. Definition standards were those recommended by Center for Disease Control-CDC- 1992. Statistical analysis was based on Qui-square test of Pearson. Of the 2,149 NNISS patients operated, 120 developed infection, thus corresponding to a general surgical- site infection rate of 5.6%. Broken down according to the Surgical Infection Risk Index-SIRI, such rates correspond to 3.2%, 7.4%, 16.6% and 20.9% for the risk-index groups 0, 1, 2 and 3, respectively. Of all NNISS surgical procedures monitored at the Service, 1,478 (68.8%) were included in SIRI 0. In that group, 47 patients developed infection, the superficial incisional being the predominant infection type, which accounted for 45 cases (95.7%). In contrast, in SIRI 3, out of the 67 surgeries (3.14% of the total), 14 developed infection, 10 of which (71.4%) were deep incisional or organ cavity infection. Out of the 120 infections occurred in 2,149 surgeries performed in the period January 1996-January 1998,39 (32.5%) were diagnosed in outpatient wards. The rates obtained under NNISS recommendations are trustworth and allow comparative studies among different institutions.