Fatores de risco associados às infecções de sítio cirúrgico pós-cesáreas

Abstract

Introduction: Cesarean section is a surgical intervention that should be used only in maternal-fetal conditions that do not allow vaginal delivery. In recent years, Brazil has exhibited high rates of cesarean sections, reaching 40% of all procedures in parturients. It is considered the greatest risk factor for puerperal infections, especially SSI (Surgical Site Infection). Objective: To determine the prevalence of SSI in postcesarean section women in the last five years; to identify the risk factors for SSI associated with postcesarean section women; to characterize the risk factors related to health care that may contribute to the development of SSI in postcesarean section women and describe the surveillance methods used to notify SSI in postcesarean section women. Methodology: This was an integrative literature review study, whose search for articles occurred in the databases of the Virtual Health Library (VHL), Scientific Electronic Library Online (Scielo), Latin American and Caribbean Literature on Health Sciences (Lilacs) and Google Scholar, whose descriptors used were: "Surgical Site Infection" and "Cesarean Section". Results and discussion: The study showed difficulty in performing epidemiological surveillance of infections by the active search method. The risk factors for SSI associated with post-surgical puerperal women were classified as: host-related; pregnancy-related and intrapartum; and procedure-related, low education, occurrence of urinary infection, anemia, hypertension, obesity and smoking, black skin color, low socioeconomic status, overweight or obesity, age > 35 years, immunosuppressive diseases (hypothyroidism), emergency cesarean delivery, intercurrences such as pre-eclampsia. Furthermore, absence of protocols in the unit, lack of hand asepsis, incorrect or absent prophylaxis, incorrect or absent dressing, and lack of knowledge of the health team. Conclusion: It was evident in this study the need for knowledge about the risk factors related to SSI after cesarean section, in order to improve the quality of care provided to patients, with attention to adequate prenatal care, antibiotic prophylaxis and care during delivery. Keywords: Surgical site infection; Cesarean section.