3 years ago

Eficácia do antibiótico profilático intraósseo versus endovenoso em cirurgias do joelho em porcos: estudo experimental

Carlos Augusto De Mattos, Nina Razzo Pereira Dos Santos, Mariana De Oliveira Cyrino, Laura Credidio, Natália Silveira Virgilli, Joaquim Simões Neto

Publication date: Available online 17 February 2018

Source: Revista Brasileira de Ortopedia

Author(s): Carlos Augusto de Mattos, Nina Razzo Pereira dos Santos, Mariana de Oliveira Cyrino, Laura Credidio, Natália Silveira Virgilli, Joaquim Simões Neto

Resumo
Objetivo

Demonstrar em 36 porcos como modelos vivos que o acesso intraósseo é mais efetivo em comparação com o endovenoso na administração de antibiótico profilático em cirurgias na articulação do joelho.

Método

Foram coletadas e analisadas amostras de pele, tecido subcutâneo, cartilagem e osso, após administração de antibiótico EV e IO (grupos diferentes), e comparadas entre si.

Resultado

A comparação entre os grupos IO e EV indicou que o grupo IO mostrou maior concentração de antibiótico profilático na pele (p = 0,049), cartilagem (p = 0,018) e osso (p = 0,002) na análise das primeiras 24 horas após 30 minutos de infusão.

Conclusão

Visto que as complicações dessa prática são raras, o uso dessa via pode ser uma opção para a diminuição do risco de infecção do sítio cirúrgico nas cirurgias ortopédicas, leva à diminuição da morbimortalidade e dos gastos hospitalares com reabordagens ou tempo prolongado de internação. Contudo, são necessários maior pesquisa e novos estudos experimentais em seres humanos, dado que está comprovada a eficácia do método em porcos.

Abstract
Objective

The main objective of the study is to demonstrate that intraosseous access is more effective compared to intravenous for prophylactic antibiotic administration in knee joint surgeries, using 36 pigs as living models.

Method

Skin, subcutaneous, cartilage, and bone samples were collected and analyzed after administration of IV antibiotic or IO (different groups), comparing with each other.

Results

When comparing IO groups with IV, the IO group showed a higher concentration of prophylactic antibiotic in the skin (p = 0.049), cartilage (p = 0.018), and bone (p = 0.002), in the analysis of the first 24 hours after 30 minutes of infusion.

Conclusion

Since complications of this practice are rare, the use of this pathway may be an alternative to reduce the risk of surgical site infection in orthopedic surgeries, leading to a decrease in morbidity and mortality and hospital expenses with re‐admission or prolonged hospitalization time. However, further research and further experimental studies in humans are required, as the effectiveness of the method in pigs has been proven.

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