RESUMO Objetivo: Identificar e descrever quais curativos são recomendados após cirurgias cardíacas, para a prevenção de infecção do sítio cirúrgico, em pacientes adultos hospitalizados. Método: Revisão integrativa realizada nas bases de dados MEDLINE, LILACS, CINAHL, Web of Science, Cochrane e Scopus. Selecionaram-se estudos relacionados ao curativo no pós-operatório de cirurgia cardíaca. Resultados: Foram incluídos sete artigos, com os seguintes curativos: terapia de feridas por pressão negativa, curativo de náilon impregnado com prata, terapia transdérmica de oxigênio contínuo e cobertura adesiva impermeável. Os curativos que apresentaram redução de infecção foram os por pressão negativa e de náilon impregnado com prata. Conclusão: Não foi possível identificar qual curativo é mais recomendado, no entanto, alguns estudos evidenciam que certos tipos de curativos foram relacionados com a redução de infecção. Sugere-se a realização de ensaios clínicos com rigorosa descrição metodológica e amostras representativas para minimizar o risco de viés e avaliar a efetividade dos curativos na prevenção de infecção do sítio cirúrgico.
Objective: identify and describe which dressings are recommended in the treatment of mediastinitis after cardiac surgery in adult patients. Method: integrative review held in the databases MEDLINE/PubMed, LILACS, CINAHL, Web of Science, Cochrane, SCOPUS and manual search, between December 2017 and January 2018. It was selected studies on dressings used in the treatment of mediastinitis after cardiac surgery. Results: eight articles were included: three addressed the treatment of negative pressure wounds and reported that most of the patients analyzed were successful in treatment, reducing the need for other interventions; four compared the previous therapy with conventional dressings and concluded that the rates of sternal reinfection and hospital mortality were lower in the first group; and one compared vacuum assisted therapy with a closed drainage system and lower rates of sternal reinfection were seen in the group undergoing vacuum treatment. Conclusion: the evidence indicates that the use of vacuum therapy to treat mediastinitis after cardiac surgery was effective. However, despite the positive outcome, clinical trials with strict methodological description and significant samples are suggested to minimize the risk of bias and to evaluate the impact of dressings in the treatment of mediastinitis.
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