Antibioticoterapia - Sociedade Brasileira de Cirurgia Plástica

Antibioticoterapia - Sociedade Brasileira de Cirurgia Plástica

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Franco T et al.
ARTIGO ORIGINAL
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Prophylactic antibiotic therapy and/or therapeutic in patients undergoing plastic surgery: a necessity?
GONÇALVES APARECIDO DIAS1
RESUMO
Introdução:$DQWLELRWLFRWHUDSLDSUR¿OiWLFDHWHUDSrXWLFDpPXLWDVYH]HVXVDGDGHIRUPD
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todo:)RUDPLQFOXtGRVQHVWHHVWXGRSDFLHQWHVVXEPHWLGRVjFLUXUJLDSOiVWLFDHVWpWLFD
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FD*UXSRSDFLHQWHVRSHUDGRVHPUHJLPHKRVSLWDODUGXUDomRVXSHULRUD
KRUDVUHFHEHUDPDQWLELRWLFRWHUDSLDSUR¿OiWLFDResultados:1RV*UXSRVHQmRKRXYH
LQIHFomRQRJUXSRKRXYHXPFDVRGHLQIHFomRQRJUXSRTXDWURRXWUR
FDVRConclusão:$QWLELRWLFRWHUDSLDSUR¿OiWLFDQmRLQÀXHQFLRXQDRFRUUrQFLDGHLQIHFomR
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WHUIHULXQDLQFLGrQFLDGHLQIHFomRHPFLUXUJLDVTXHWLYHUDPGXUDomRDFLPDGHWUrVKRUDV
Descritores:&LUXUJLDSOiVWLFD$JHQWHVDQWLEDFWHULDQRV&RQWUROHGHLQIHFo}HV
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SUMMARY
Introduction:$QWLELRWLFWKHUDS\DQGWKHUDS\LVRIWHQXVHGLQHUURUE\WKHVXUJHRQWRSUH-­
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DHVWKHWLFSODVWLFVXUJHU\Methods:7KLVVWXG\LQFOXGHGSDWLHQWVZKRXQGHUZHQWSODVWLF
VXUJHU\EHWZHHQDQGGLYLGHGLQWRIRXUJURXSV*URXSSDWLHQWRSHUDWHGLQ
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DQWLELRWLFVResults: ,Q*URXSVHWKHUHZDVQRLQIHFWLRQLQ*URXSZDVRQH
FDVHRILQIHFWLRQDQGLQ*URXSDQRWKHUFDVHConclusion:3URSK\ODFWLFDQWLELRWLF
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Rev. Bras. Cir. Plást. 2010;; 25(3): 423-­7
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MÉTODO
,QFOXLXVHQHVVHHVWXGRRVSDFLHQWHVVXEPHWLGRVjFLUXUJLD
SOiVWLFDHVWpWLFDHQWUHRVDQRVGHHWRWDOL]DQGRGH
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FRP DQWLPLFURELDQRV IRL LQLFLDGD DSyV D DOWD KRVSLWDODU R
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VHJXLQWHPDQHLUD
‡ Grupo 1 -­ 3DFLHQWHVVXEPHWLGRVjFLUXUJLDSOiVWLFDHVWp-­
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)RUDPRSHUDGRVQRVDQRVGHHSDFLHQWHV
WRGRVUHFHEHUDPDQWLELRWLFRWHUDSLDSUR¿OiWLFD$VFLUXU-­
JLDVUHDOL]DGDVIRUDPEOHIDURSODVWLDVULQRSODVWLDV
HRWRSODVWLDV
‡ Grupo 2 -­ 3DFLHQWHVVXEPHWLGRVjFLUXUJLDSOiVWLFDHVWp-­
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HVWpWLFD HP UHJLPH KRVSLWDODU FRP GXUDomR VXSHULRU D
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DXPHQWRHliftingIDFLDO
‡ Grupo 4 -­ 3DFLHQWHV VXEPHWLGRV j FLUXUJLD SOiVWLFD
HVWpWLFD HP UHJLPH KRVSLWDODU FRP GXUDomR VXSHULRU D
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PDPRSODVWLDVGHUHGXomRPDPRSODVWLDVGHDXPHQWR
e 22 lifting IDFLDO
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RESULTADOS
1RVJUXSRVXPHGRLVQmRKRXYHFDVRVGHLQIHFomR
1RJUXSRWUrVKRXYHXPFDVRGHLQIHFomRHP
FLUXUJLDGHPDPRSODVWLDGHDXPHQWRGLDJQRVWLFDGRDRQRQR
GLD GH SyVRSHUDWyULR TXDQGR KRXYH VDtGD GH VHFUHomR
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ERPHVWDGRJHUDOVHPVLQDLVGHLQIHFomRVLVWrPLFDFROKLGR
PDWHULDOSDUDH[DPHVDWUDYpVGHSXQomRGDORMDDJXDUGRXVH
RUHVXOWDGRGDFXOWXUDHDQWLELRJUDPDIRLIHLWRWUDWDPHQWR
FOtQLFR VHP VXFHVVR H R FDVR HYROXLX SDUD UHWLUDGD GR
LPSODQWH
1RJUXSRTXDWURKRXYHXPFDVRGHLQIHFomRHP
DEGRPLQRSODVWLDIHEUHTXHGDGRHVWDGRJHUDOOHXFRFLWRVH
GLDJQRVWLFDGRQRTXLQWRGLDSyVRSHUDWyULRTXHHYROXLXFRP
DEVFHVVRORFDOL]DGRQRVXEFXWkQHRGDUHJLmRHSLJiVWULFD2
GLDJQyVWLFR IRL IHLWR SRU XOWUDVVRQRJUD¿D R SURFHGLPHQWR
GH GUHQDJHP IRL IHLWR FRP GUHQR GH VXFomR IHFKDGR QR
ORFDOLQLFLRXVHDQWLELRWLFRWHUDSLDKRVSLWDODUHPStULFDSRLV
DSDFLHQWHDSUHVHQWDYDVLQDLVGHLQIHFomRVLVWrPLFDHSRVWH-­
ULRUPHQWH GH DFRUGR FRP FXOWXUD H DQWLELRJUDPD R GUHQR
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SDFLHQWH WHYH ERD HYROXomR FRP R WUDWDPHQWR LQVWLWXtGR H
UHFHEHXDOWDKRVSLWDODUDVVLQWRPiWLFD
DISCUSSÃO
$LQIHFomRHPFLUXUJLDSOiVWLFDSRGHVHUGHVDVWURVDSRLV
DOpPGHFRPSURPHWHURUHVXOWDGRGDFLUXUJLDFRORFDHPULVFR
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EDVWDQWHWHPLGDHDSHVDUGHHVWXGRVJHUDLVLQGLFDUHPDIRUPD
FRUUHWDSDUDRXVRGHDQWLELyWLFRVHPFLUXUJLDSOiVWLFDVmR
SRXFRVRVWUDEDOKRVFLHQWt¿FRVTXHWUDWDPVREUHRWHPD
$ DQWLELRWLFRWHUDSLD SUR¿OiWLFD H WHUDSrXWLFD p WiWLFD
PXLWDVYH]HVXVDGDGHPRGRHTXLYRFDGRSHORFLUXUJLmRSOiV-­
WLFRFRPDLQWHQomRGHHYLWDURDSDUHFLPHQWRGHLQIHFomRQR
VtWLRFLU~UJLFR$WHUDSrXWLFDFRPDQWLPLFURELDQRVGHYHVHU
IHLWDDSHQDVTXDQGRKiGLDJQyVWLFRLQHTXtYRFRGHLQIHFomR
p QHFHVViULR WHUPRV FRQVFLrQFLD TXH R XVR LQGLVFULPLQDGR
GH DQWLELyWLFRV QmR SUHYLQH LQIHFomR PDV SRU RXWUR ODGR
VHOHFLRQD EDFWpULDV TXH HVWmR FDGD YH] PDLV UHVLVWHQWHV
j DQWLELRWLFRWHUDSLD Mi H[LVWHP UHODWRV GH Staphylococus aureus UHVLVWHQWHV j YDQFRPLFLQD RX VHMD SRGHUHPRV D
TXDOTXHUPRPHQWRQRVGHSDUDUFRPXPTXDGURLQIHFFLRVRGH
GLItFLOWUDWDPHQWRSRUFRQWDGHXPDEDFWpULDPXOWLUUHVLVWHQWH
Rev. Bras. Cir. Plást. 2010;; 25(3): 423-­7
$QWLELRWLFRWHUDSLDSUR¿OiWLFDHRXWHUDSrXWLFDHPSDFLHQWHVVXEPHWLGRVjFLUXUJLDSOiVWLFDHVWpWLFD
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WUDWDPHQWRVHJXURSDUDRVQRVVRVSDFLHQWHV
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HP FLUXUJLD SOiVWLFD HVWpWLFD VHMD EDL[D p UHVSRQViYHO SRU
Do}HV MXGLFLDLV FRQWUD KRVSLWDLV FOtQLFDV H PpGLFRV
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UDWXUDPpGLFDHVSHFLDOL]DGDVHQGRLPSRUWDQWHTXHQHVWDV
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UHQoDHVWDWtVWLFDHQWUHRV*UXSRVHTXHXVDUDPDQWLELR-­
WLFRWHUDSLD SUR¿OiWLFD RX QmR XVDUDP UHVSHFWLYDPHQWH RX
VHMDSDUDFLUXUJLDVFRPDWpKRUDVGHGXUDomRQmRKRXYH
LQIHFomRXVDQGRRXQmRDQWLELyWLFRV
2PHVPRVHREVHUYDTXDQGRFRPSDUDPRVR*UXSRTXH
XVRX DQWLELRWLFRWHUDSLD SUR¿OiWLFD H WHUDSrXWLFD H R JUXSR
TXDWUR QR TXDO IRL IHLWR DSHQDV SUR¿OD[LD FRP DQWLPLFUR-­
ELDQRVSRLVQHVVHVJUXSRVHPTXHDVFLUXUJLDVWLYHUDPXP
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SDUDFDGDJUXSRPRVWUDQGRTXHRXVRSURORQJDGRGHDQWLELy-­
WLFRV*UXSRQmRWHYHLQÀXrQFLDQDLQFLGrQFLDGHLQIHFomR
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FLUXUJLDVSOiVWLFDVHVWpWLFDV
CONCLUSÃO
$DQWLELRWLFRWHUDSLDSUR¿OiWLFDQmRLQÀXHQFLRXQDRFRU-­
UrQFLDGHLQIHFomRHPFLUXUJLDVTXHGXUDUDPDWpGXDVKRUDV
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2XVRGHDQWLELRWLFRWHUDSLDWHUDSrXWLFDQmRLQWHUIHULXQD
LQFLGrQFLDGHLQIHFomRQRVSDFLHQWHVVXEPHWLGRVjFLUXUJLD
Correspondência para:
SOiVWLFDHVWpWLFDTXHWLYHUDPGXUDomRVXSHULRUDWUrVKRUDV
DEGRPLQRSODVWLDPDPRSODVWLDHlifting IDFLDO
REFERÊNCIAS
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UHVPXOWLUUHVLVWHQWHVHPSDFLHQWHVFUtWLFRVFLU~UJLFRVHFOtQLFRVHXP
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Gonçalves Aparecido Dias
Rua Anhanguera, 930 – Cidade Universitária – Ituverava, SP, Brasil – CEP 14500-000
E-mail: [email protected]
Rev. Bras. Cir. Plást. 2010;; 25(3): 423-­7
427