Palabras clave
Infección de la herida quirúrgica
Telemedicina
Cómo citar
Copyright © | Todos los derechos reservados.
La revista posee los derechos de autor exclusivos para la publicación de este artículo en los términos de la ley brasileña 9610/98.
Reproducción parcial
El uso de partes de los textos, figuras y cuestionario del artículo es libre, siendo obligatoria la citación de los autores y revista.
Reproducción total
Está expresamente prohibido y debe ser autorizado por la revista.
Resumen
Objetivo: Identificar la efectividad de la telesalud en la detección de infecciones en heridas quirúrgicas a través de la evidencia en la literatura científica. Métodos: Se trata de una revisión integradora, realizada en las bases de datos EMBASE, PubMed, Scopus y Web of Science, utilizando los siguientes descriptores: “telemedicine”, “telehealth”, “digital health”, “surgical site infection”, “surgical wound” y “surgical wound infection”. Se incluyeron estudios publicados entre 2018 y 2024 que incluyeron pacientes posoperatorios evaluados mediante métodos de telesalud. Resultados: La muestra final estuvo compuesta por 11 artículos, con mayor concentración de publicaciones en los años 2023 y 2021. La mayoría de los estudios se realizaron en el Reino Unido y los diseños de investigación predominantes fueron los estudios de cohortes. Se ha descubierto que la telesalud aumenta significativamente la eficacia diagnóstica y terapéutica en la detección temprana de infecciones en heridas quirúrgicas, proporcionando una fuerte correlación entre las evaluaciones en persona y a distancia y reduciendo la necesidad de seguimiento en persona. Consideraciones finales: esta revisión destaca el potencial de la telesalud en el seguimiento de heridas quirúrgicas, destacando mejoras en la eficacia del diagnóstico y la accesibilidad a la atención. Desafíos como la necesidad de estandarizar las técnicas de monitorización y la inclusión de pacientes menos familiarizados con la tecnología apuntan a áreas críticas para futuras investigaciones.
Referencias
ABU-SHEASHA GA, et al. Cost-effectiveness analysis of three methods of surgical-site infection surveillance: less is more. Am. J. Infect. Control. 2020; 48(10): 1220–1224.
ALLEGRANZI B, et al. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infect Dis. 2016; 16(12): e276-e287.
BANIASADI T, et al. Developing a mobile health application for wound telemonitoring: a pilot study on abdominal surgeries post-discharge care. BMC Med Inform Decis Mak. 2023; 23(1): 103.
BARROS CSM. Custos atribuídos às infecções de sítio cirúrgico em um hospital universitário em Salvador-Bahia. Tese (Doutorado em Biotecnologia em Saúde e Medicina Investigativa) – Fundação Oswaldo Cruz, Centro de Pesquisas Gonçalo Moniz, 2016.
BLUEBELLE STUDY GROUP. Validation of the Bluebelle Wound Healing Questionnaire for assessment of surgical-site infection in closed primary wounds after hospital discharge. Br. J. Surg. 2019; 106(3): 226–235.
BRASIL. Ministério da Saúde (MS). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde, 1998.
BRAZ NJ, et al. Infecção do sítio cirúrgico em pacientes submetidos a cirurgias cardíacas: uma análise do perfil epidemiológico. Rev Enfermagem Centro-Oeste Mineiro. 2018; 8:e1793.
BRUCE J, et al. Wound photography for evaluation of surgical site infection and wound healing after lower limb trauma. Bone Joint J. 2021; 103-B (12): 1802-1808.
CALEGARI IB, et al. Métodos para vigilância de infecção do sítio cirúrgico pós-alta: revisão integrativa. Acta Paul Enferm. 2023; 36:eAPE019631.
CHERIAN T, et al. Diagnosing post-cesarean surgical site infections in rural Rwanda: development, validation, and field testing of a screening algorithm for use by community health workers. Surg. Infect. 2020; 21(7):613–620.
CROTHERS H, et al. Outcomes for surgical procedures funded by the English health service but carried out in public versus independent hospitals: a database study. BMJ Qual Saf. 2022; 31(7): 515-525.
DAVIS C, et al. Feasibility and acute care utilization outcomes of a post-acute transitional telemonitoring program for underserved chronic disease patients. Telemed J E Health. 2015; 21:705-713.
GAGLIOTTI C, et al. Use of health databases to deal with underreporting of surgical site infections due to suboptimal post-discharge follow-up. J Hosp Infect. 2020; 104(2): 239-42.
GUNTER RL, et al. Feasibility of an image-based mobile health protocol for postoperative wound monitoring. J. Am. Coll. Surg. 2018; 226(3): 277–286.
HALEEM A, et al. Telemedicine for healthcare: Capabilities, features, barriers, and applications. Sensors International. 2021; 2:100117.
IANNUZZI JC, et al. Risk score for unplanned vascular readmissions. J Vasc Surg. 2014; 59: 1340-1347.e1.
LATHAN R, et al. Diagnostic accuracy of telemedicine for detection of surgical site infection: a systematic review and meta-analysis. NPJ Digit Med. 2022; 5:108.
LIU Z, et al. Intraoperative interventions for preventing surgical site infection: an overview of Cochrane Reviews. Cochrane Database Syst Rev., 2018; 2(2): CD012653.
MACEFIELD RC, et al. Remote assessment of surgical site infection (SSI) using patient-taken wound images: Development and evaluation of a method for research and routine practice. J Tissue Viability. 2023; 32(1): 94-101.
MARTINS T, et al. Risk factors for surgical site infections in potentially contaminated surgeries. Texto Contexto Enferm. 2018; 27(3): e2790016.
MCHUGH ML. Interrater reliability: the kappa statistic. Biochemia Medica, 2012; 22(3): 276-282.
MCLEAN KA, et al. Remote diagnosis of surgical-site infection using a mobile digital intervention: a randomised controlled trial in emergency surgery patients. npj Digital Med. 2021; 4(1): 160.
MCLEAN KA, et al. Evaluation of remote digital postoperative wound monitoring in routine surgical practice. NPJ Digit Med. 2023; 6(1): 85.
MERKOW RP, et al. Underlying reasons associated with hospital readmission following surgery in the United States. JAMA. 2015; 313(5): 483‐495.
MOUSA AY, et al. Results of telehealth electronic monitoring for post discharge complications and surgical site infections following arterial revascularization with groin incision. Ann. Vasc. Surg. 2019; 57: 160–169.
OWENS PL, et al. Surgical site infections following ambulatory surgery procedures. Jama. 2014; 311: 709–716.
PAGAMISSE AF, et al. post-discharge surveillance of surgical site infections in teaching hospitals in Brazil. Rev Esc Enferm USP. 2020; 54: e03542.
PUROHIT A, et al. Does telemedicine reduce the carbon footprint of healthcare? A systematic review. Future Health. J. 2021; 8: e85–e91.
ROSA R, et al. Preventing Surgical Site Infections: Implementing Strategies Throughout the Perioperative Continuum. AORN J. 2023; 117(5): 300-311.
SANGER PC, et al. Patient perspectives on post-discharge surgical site infections: towards a patient-centered mobile health solution. PLoS ONE. 2014; 9: e114016.
SOUZA MT, et al. Integrative review: what is it? How to do it? Einstein (Sao Paulo). 2010; 8(1): 102-6.
STEWART S, et al. Epidemiology of healthcare-associated infection reported from a hospital-wide incidence study: Considerations for infection prevention and control planning. J. Hosp. Infect. 2021; 114: 10–22.
STILLWELL S, et al. Evidence– based practice: step by step. Am J Nurs, 2010; 110(5): 41-47.
TAKO KV, et al. Metodologia da pesquisa científica: dos conceitos teóricos à construção do projeto de pesquisa. Campina Grande: Editora Amplla, 2023.
TOTTY JP, et al. Use of photograph-based telemedicine in postoperative wound assessment to diagnose or exclude surgical site infection. J. Wound Care. 2018; 27(3): 128–135.
WENZEL RP. Surgical site infections and the microbiome: An updated perspective. Infect Control Hosp Epidemiol. 2019; 40(5): 590-596.
WISEMAN JT, et al. Predictors of surgical site infection after hospital discharge in patients undergoing major vascular surgery. J Vasc Surg 2015; 62: 1023–1031.
WISEMAN JT, et al. Inter-rater agreement and checklist validation for postoperative wound assessment using smartphone images in vascular surgery. J Vasc Surg Venous Lymphat Disord 2016; 4: 320–328.e2.