Revestimento cutâneo de Cianocrilato para pacientes submetidos à cirurgia cardiotorácica: revisão sistemática da literatura

Abstract

Objective: To compare the effectiveness of conventional dressings and / or sutures with cyanoacrylate coatings for the reduction of mediastinitis rates in cardiothoracic surgeries. Methods: Systematic review of the literature conducted according to the recommendations of the Cochrane Handbook. The PRISMA protocol was used as a guide for the systematic review. We searched for randomized controlled trials with no limitations on language and year of publication in the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS), Medical Literature Analysis and Retrieval System (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), National Library of Medicine (PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), Virtual Health Library (VHL), Web of Science, Science Direct, Central Cochrane Library and Repository of Gray Literature using the controlled and uncontrolled descriptors. It was also searched in the gray literature, in ANAIS of Congresses, in specific bases on the studied subject and in the references of the references with the purpose of exhausting the literature. Prior to the data analysis, a bias risk control form was used. Results: Four studies (2092 participants) aged 45 to 81 years who used cyanoacrylate in sternotomies were included in order to reduce mediastinitis rates. The studies were consistent with the proposed outcomes and presented a low risk of bias in the areas of the Cochrane Collaboration bias risk table except in the areas of secrecy and masking, since the studies involved surgical procedures. The selected studies responded to the primary outcome of this study, namely reduction of mediastinitis index with the use of cyanoacrylate, but did not respond to proposed secondary outcomes that were reduced hospitalization time and reduced treatment costs. Conclusions: The use of cyanoacrylate based coatings is equivalent to traditional skin preparation in cardiac surgeries, as it does not significantly influence the incidence of Surgical Site Infection (ISC). However, the use of cyanoacrylate decreased the incidence of SSI in groups more prone to infection, namely: elderly patients with chronic diseases (systemic arterial hypertension, Diabetes Mellitus or vascular diseases) and obese patients.