RESUMO
OBJECTIVE: to determine the direct and indirect costs in the High Specialty Medical Unit Hospital de Traumatology y Orthopedic "Lomas Verdes" of the pathology of complex hand trauma classified as occupational risk. MATERIAL AND METHODS: 50 complete clinical records with a diagnosis of complex hand trauma were analyzed from January 2019 to August 2020. The perspective of the study is to determine the costs of medical care for complex hand trauma in active workers. RESULTS: 50 clinical records of patients with clinical and radiological diagnosis of trauma severe de mano, insured workers with a work risk opinion, were reviewed. CONCLUSION: the presence of these injuries in the active age of our patients speaks to us of the great importance of timely and adequate care for severe hand trauma, which has a significant impact on the country's economy. Hence the great need to establish methods of prevention of such injuries in companies and the need to establish medical care protocols for these injuries and seek to reduce surgical procedures to resolve this pathology.
OBJETIVO: determinar los costos directos e indirectos en la Unidad Médica de Alta Especialidad, Hospital de Traumatología y Ortopedia "Lomas Verdes" de la patología del trauma complejo de mano calificado como riesgo de trabajo. MATERIAL Y MÉTODOS: se analizaron 50 expedientes clínicos completos con diagnóstico de trauma complejo de mano de Enero de 2019 a Agosto de 2020. La perspectiva del estudio es determinar los costos de la atención médica del trauma complejo de mano en trabajadores activos. RESULTADOS: se revisaron 50 expedientes clínicos de pacientes con diagnóstico clínico y radiológico de trauma severo de mano, trabajadores asegurados con dictamen de riesgo de trabajo. CONCLUSIÓN: la presencia de estas lesiones en la edad activa de nuestros pacientes nos habla de la gran importancia que conlleva una atención oportuna y adecuada del trauma severo de mano, que impacta de manera importante en la economía del país. De ahí de la gran necesidad de establecer métodos de prevención de dichas lesiones en las empresas y la necesidad de establecer protocolos de atención médica para estas lesiones y buscar disminuir los procedimientos quirúrgicos para resolver esta patología.
Assuntos
Traumatismos da Mão , Ortopedia , Traumatologia , Humanos , Traumatismos da Mão/terapia , HospitaisRESUMO
INTRODUCTION: Hand injuries constitute 6.6% to 28.6% of all injuries in the musculoskeletal system. Little information has been reported on the non-laboring, non-insured population with no social security. We describe the epidemiology of hand and wrist injuries treated over a year in the emergency department of a reference hospital in Mexico City that treats patients with no social security. OBJECTIVE: To describe the epidemiology of hand and wrist injuries treated in the ED of a high specialty reference medical facility over a year. MATERIAL AND METHODS: Medical records for patients treated for hand and wrist injuries in the emergency department in 2015 were reviewed. A descriptive statistical analysis was performed. RESULTS: Hand and wrist injuries constituted 8.9% of all emergencies treated in the emergency department of INR-LGII during 2015. Young, male patients, between 21 and 30 years of age were the most commonly affected age group. Students and housewives constituted almost half the population treated for hand and wrist injuries. The most common injuries were fractures, contusions and sprains. CONCLUSION: Hand and wrist injuries are common. There is currently not enough epidemiological data on non-laboring hand injuries in Mexico or the world. Hand and wrist injuries need to receive specialized treatment to avoid complications and permanent disability.
INTRODUCCIÓN: Las lesiones en las manos constituyen entre 6.6 y 28.6% de las lesiones del sistema musculoesquelético. Existe poca información en el mundo sobre las lesiones de las manos en la población sin seguridad social y no trabajadora. Describimos la epidemiología de las lesiones de mano y muñeca tratadas durante un año en el Servicio de Urgencias de un Centro de Tercer Nivel de la Ciudad de México que trata a pacientes sin seguridad social. OBJETIVO: Describir la epidemiología de las lesiones de mano y muñeca tratadas durante un año en el servicio de urgencias de un Centro Hospitalario de Tercer Nivel. MATERIAL Y MÉTODOS: Revisión de expedientes electrónicos de los pacientes tratados por lesiones de mano y muñeca en el servicio de urgencias durante 2015. Se llevó a cabo un análisis estadístico descriptivo. RESULTADOS: Las lesiones de mano y muñeca constituyeron 8.9% de todas las emergencias tratadas en el Servicio de Urgencias del Instituto Nacional de Rehabilitación "Luis Guillermo Ibarra Ibarra" (INR-LGII) durante 2015. Los pacientes hombres, jóvenes entre 21 y 30 años de edad fueron el grupo más afectado. Los estudiantes y amas de casa fueron casi la mitad de la población tratada por lesiones de mano y muñeca. Las lesiones más comúnmente tratadas fueron fracturas, contusiones y esguinces. CONCLUSIÓN: Las lesiones de mano y muñeca son comunes y requieren tratamiento especializado oportuno para evitar complicaciones y discapacidad permanente.
Assuntos
Fraturas Ósseas , Traumatismos da Mão , Traumatismos do Punho , Serviço Hospitalar de Emergência , Fraturas Ósseas/epidemiologia , Mãos , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/terapia , Humanos , Masculino , Traumatismos do Punho/epidemiologia , Traumatismos do Punho/terapiaAssuntos
Traumatismos por Explosões/etiologia , Sistemas Eletrônicos de Liberação de Nicotina , Traumatismos da Mão/etiologia , Nebulizadores e Vaporizadores , Adolescente , Antibacterianos/uso terapêutico , Traumatismos por Explosões/terapia , Desbridamento/métodos , Traumatismos da Mão/terapia , Humanos , MasculinoRESUMO
STUDY DESIGN: A male patient with partial hand amputation of his nondominant hand, with only stumps of the proximal phalanx of the first and fifth finger, was evaluated. The performance of using two alternative 3D printed silicone-embedded personalized prostheses was evaluated using the quantitative Jebsen Hand Function Test. INTRODUCTION: Custom design and fabrication of 3D printed prostheses appears to be a good technique for improving the clinical treatment of patients with partial hand amputations. Despite its importance the literature shows an absence of studies reporting on quantitative functional evaluations of 3D printed hand prostheses. PURPOSE OF THE STUDY: We aim at producing the first quantitative assessment of the impact of using 3D printed silicone-embedded prostheses that can be fabricated and customized within the clinical environment. METHODS: Alginate molds and computed tomographic scans were taken from the patient's hand. Each candidate prosthesis was modeled in Computer Aided Design software and then fabricated using a combination of 3D printed parts and silicone-embedded components. DISCUSSION: Incorporating the patient's feedback during the design loop was very important for obtaining a good aid on his work activities. Although the explored patient-centered design process still requires a multidisciplinary team, functional benefits are large. CONCLUSION(S): Quantitative data demonstrates better hand performance when using 3D printed silicone-embedded prosthesis vs not using any aid. The patient accomplished complex tasks such as driving a nail and opening plastic bags. This was impossible without the aid of produced prosthesis.
Assuntos
Membros Artificiais , Lesões por Esmagamento/terapia , Traumatismos da Mão/terapia , Mãos , Impressão Tridimensional , Desenho de Prótese , Lesões por Esmagamento/diagnóstico por imagem , Traumatismos da Mão/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , SiliconesRESUMO
Las fracturas de los metacarpianos constituyen el 10% del total de las fracturas(¹) y representan un 30%-50% de las fracturas de la mano(²). La fractura del cuello del quinto metacarpiano es la más frecuente, también llamada Boxer fracture, corresponde al 20% de todas las fracturas de la mano. Para la gran mayoría de estas fracturas la literatura actual avala el tratamiento conservador, ya que son estables desde el principio o luego de una reducción cerrada(¹). Se calcula que apenas un 5% tienen indicación quirúrgica. El propósito de nuestra revisión bibliográfica fue establecer los diferentes criterios que se utilizan para tratar en forma quirúrgica o no las fracturas no articulares de los metacarpianos excluido el primer dedo. Para ello realizamos una revisión sistematizada de los últimos diez años en mayores de 18 años, obteniendo 19 artículos que cumplían con nuestros criterios de inclusión. Nuestra estrategia de análisis fue revisar las indicaciones terapéuticas, frecuencia y justificaciones. Esta revisión sistematizada se organiza en tres grupos de trabajos, aquellos que se ocupaban del tratamiento ortopédico, los que indicaban el tratamiento quirúrgico y los que comparaban los resultados de ambos tratamientos entre sí. De sus resultados se puede concluir que no existe una indicación quirúrgica universalmente recomendada, ya que la literatura carece de estudios con nivel de evidencia I o II que vayan en esa dirección. De nuestra revisión se extrae cuáles son las indicaciones quirúrgicas más frecuentemente aceptadas en la literatura. Destacándose la angulación dorsal mayor a 30 grados, la malrotación y el acortamiento, los cuales determinan secuelas graves como el crossfinger, la pérdida de extensión o de fuerza de prensión. Finalmente, al no existir un consenso y hasta no contar con la suficiente evidencia científica, la decisión de la estrategia terapéutica recae sobre el cirujano ortopedista, quien debe elegirla según su experiencia, teniendo en cuenta la personalidad de la fractura, los materiales disponibles y la literatura revisada que lo avale.
Abstract Metacarpal fractures constitute 10% of the total number of fractures(1) and they represent 30%-50% of hand fractures(2). Fracture of the fifth metacarpal neck is the most frequent one, also called Boxer fracture, corresponding to 20% of all hand fractures. Literature favors a conservative treatment for most of these fractures, since they are stable from the beginning or after a closed reduction. Our bibliographic review aims to define the different criteria used to treat extra-articular metacarpal fractures excluding the thumb, with or without surgery. To that end, we conducted a systematized review of the last 10 years in patients over 18 years old, obtaining 19 articles that met our inclusion criteria. Our analysis strategy was to review therapy indications, frequency and justification. Systematized revision was divided into three groups of work: those who dealt with orthopedic treatment, those who indicated surgical treatment and those who compared results between the two treatments. Results led to the conclusion that there is no surgical indication that is universally recommended, since literature lacks Level I or II studies on this matter. Our review reveals the most frequently accepted surgical indications in literature. Dorsal angulation exceeding 30 degrees, malrotation and shortening stand out, all of which result in severe sequelae such as crossfinger, loss of extension or grip strength. Last, there being no consensus and until there is enough scientific evidence, decisions on therapeutic strategies are to the orthopedic surgeon, which decision shall be based on their experience, considering the kind of fracture, materials available and reviewed literature that supports it.
Resumo As fraturas dos metacarpianos correspondem a 10% das fraturas em geral(1) e a 30%-50% das fraturas da mão(2). A fratura do colo do quinto metacarpiano, também conhecida como Boxer fracture, é a mais frequente - 20% das fraturas da mão. A literatura atual apoia o tratamento conservador para a grande maioria destas fraturas, pois são estáveis desde o começo ou depois de uma redução fechada(1). Calcula-se que apenas 5% tem indicação cirúrgica. O objetivo desta revisão bibliográfica foi identificar os diferentes critérios utilizados para tratar, cirurgicamente ou não, as fraturas não articulares dos metacarpianos excluindo o primeiro dedo. Realizamos una revisão sistemática da literatura científica dos últimos dez anos que incluíam pacientes maiores de 18 anos; 19 artigos foram selecionados por seguir os critérios de inclusão. A estratégia da análise foi revisar as indicações terapêuticas, frequência e justificativas. Os artigos foram organizados em três grupos: tratamento ortopédico, tratamento cirúrgico e os que comparavam os resultados de ambos os tratamentos. A análise dos resultados mostrou que não se pode concluir que exista una indicação cirúrgica universalmente recomendada, pois a literatura carece de estudos com níveis de evidencia I ou II que considerem esses aspectos. Entre as indicações cirúrgicas mais frequentemente aceitas na literatura se destacam a angulação dorsal maior a 30 graus, má rotação e encurtamento, que determinam sequelas graves como o crossfinger, a perda da extensão ou da força de preensão. Finalmente, como não existe um consenso e enquanto não houver suficiente evidencia científica, a decisão sobre a estratégia terapêutica cabe ao ortopedista, que deve basear-se em sua experiência, considerando as características da fratura, os materiais disponíveis e a literatura disponível.
Assuntos
Humanos , Ossos Metacarpais , Fraturas Ósseas/terapia , Traumatismos da Mão/terapiaRESUMO
INTRODUCCIÓN: la artrosis de la articulación basal del pulgar es la más común de las enfermedades degenerativas articulares de la mano. La trapezoidectomía con o sin interposición y con o sin ligamentoplastia, es una de las opciones de tratamiento quirúrgico. OBJETIVO: mostrar los resultados obtenidos con la técnica de trapezoidectomía parcial y artroplastia por interposición, así como caracterizar algunas variables que pueden estar en relación con esta enfermedad. MÉTODOS: estudio de intervención longitudinal prospectivo con pacientes diagnosticados e intervenidos por rizoartrosis de la mano, entre enero de 2009 y enero de 2013 y valorados un año después. La muestra quedó constituida por 45 pacientes, 29 mujeres y 16 hombres. RESULTADOS: existió predominio del sexo femenino y del grupo de edades entre 51 y 60 años, mayoritariamente en pacientes que desempeñaban labores de tipo manual, con estadios de degeneración avanzados y afectación de la mano derecha dominante. Ocurrieron pocas complicaciones menores y significativos cambios en la percepción del dolor, la oposición del pulgar y en el nivel de discapacidad presente antes de la intervención. CONCLUSIONES: la trapezoidectomía parcial con artroplastia interposicional tendinosa resulto altamente efectiva en el tratamiento de la artrosis carpometacarpiana del pulgar demostrado a través del índice QuickDASH.
INTRODUCTION: Osteoarthritis of the basal joint of the thumb is the most common degenerative joint disease of the hand. Trapezoidectomy, with or without interposition and with or without ligamentoplasty, is one of the surgical treatment options. OBJECTIVE: Show the results obtained with the technique of partial trapezoidectomy and interposition arthroplasty and characterize some variables that may be related to this disease. METHODS: A prospective longitudinal intervention study was carried out with patients diagnosed and treated for hand rizoarthrosis from January 2009 to January 2013, and they were assessed a year later. The sample was composed of 45 patients: 29 women and 16 men. RESULTS: There was predominance of females, and the age group between 51 and 60 years, mostly in patients who performed manual labor with advanced stages of degeneration and disruption of the dominant right hand. A few minor complications and significant changes occurred in the perception of pain, thumb opposition and the present level of disability before surgery. CONCLUSIONS: partial tendon interpositional trapezoidectomy with arthroplasty resulted highly effective in tretaing osteoarthritis of the thumb carpometacarpal shown through QuickDASH index.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Osteoartrite/terapia , Artroplastia/métodos , Artroplastia/reabilitação , Polegar/lesões , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/terapia , Estudos Prospectivos , Estudos Longitudinais , Ensaio ClínicoRESUMO
Phosphoric acid has been suggested as an irrigant due to its effectiveness in removing the smear layer. Objectives : The purpose of this study was to compare the antimicrobial and cytotoxic effects of a 37% phosphoric acid solution to other irrigants commonly used in endodontics. Material and Methods : The substances 37% phosphoric acid, 17% EDTA, 10% citric acid, 2% chlorhexidine (solution and gel), and 5.25% NaOCl were evaluated. The antimicrobial activity was tested against Candida albicans, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Actinomyces meyeri, Parvimonas micra, Porphyromonas gingivalis, and Prevotella nigrescens according to the agar diffusion method. The cytotoxicity of the irrigants was determined by using the MTT assay. Results : Phosphoric acid presented higher antimicrobial activity compared to the other tested irrigants. With regard to the cell viability, this solution showed results similar to those with 5.25% NaOCl and 2% chlorhexidine (gel and solution), whereas 17% EDTA and 10% citric acid showed higher cell viability compared to other irrigants. Conclusion : Phosphoric acid demonstrated higher antimicrobial activity and cytotoxicity similar to that of 5.25% NaOCl and 2% chlorhexidine (gel and solution). .
Assuntos
Humanos , Masculino , Adulto Jovem , Queimaduras/etiologia , Oxigenoterapia Hiperbárica/métodos , Irídio/efeitos adversos , Exposição Ocupacional/efeitos adversos , Lesões por Radiação/terapia , Queimaduras/fisiopatologia , Queimaduras/terapia , Terapia Combinada , Seguimentos , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/terapia , Escala de Gravidade do Ferimento , Saúde Ocupacional , Lesões por Radiação/diagnóstico , Resultado do Tratamento , Cicatrização/fisiologiaRESUMO
O trauma da mão é uma das lesões mais frequentes nas emergências. O trauma complexo envolve lesões de múltiplas estruturas e tecidos da mão. O objetivo principal deste trabalho é esclarecer os conceitos envolvidos no estudo do paciente com trauma complexo da mão, mais especificamente, na avaliação inicial e manejo primário da mão traumatizada. Procuramos orientar a conduta dos médicos nas diversas situações clínico-cirúrgicas, que envolvem esta patologia, objetivando um julgamento rápido e adequado, interferindo positivamente no desenvolvimento natural da doença, como também nas sequelas decorrentes ao traumatismo. Nesta primeira parte, são abordados os fundamentos e conceitos considerados essenciais na abordagem do traumatismo da mão, lesão vascular, lesão nervosa e lesão tendínea, enfatizando os benefícios de uma conduta multifatorial e assertiva, abarcando as diversas disciplinas envolvidas no atendimento primário do paciente vítima de trauma (AU)
Trauma of the hand is one of the most frequent injuries in emergencies. Complex trauma involves injuries to multiple tissues and structures of the hand. The main purpose of this work is to clarify the concepts involved in the study of patients with complex trauma of the hand, more specifically, the initial assessment and primary management of the traumatized hand. We seek to guide the conduct of physicians in different clinical and surgical situations involving this pathology. Aiming for a quick and proper judgment, interfering positively with the natural development of the disease and also with sequelae resulting from trauma. In this first part the article discusses the fundamentals and concepts considered essential in the management of hand trauma, vascular injury, nerve injury and tendon injury, emphasizing the benefits of a multifactorial and assertive approach, covering the various disciplines involved in primary care of the trauma patient (AU)
Assuntos
Humanos , Traumatismos da Mão/diagnóstico , Traumatismos da Mão/terapia , Traumatismos dos Tendões/diagnóstico , Traumatismos dos Tendões/terapia , Lesões do Sistema Vascular/diagnóstico , Lesões do Sistema Vascular/terapia , Traumatismos dos Nervos Periféricos/diagnóstico , Traumatismos dos Nervos Periféricos/terapiaRESUMO
The protocols and published results on hand transplantation show acceptable results of this technology. None of the registered groups, however has a sufficient number of patients to allow continuity of the process. In Colombia the main problems are violence, drug traffic, and guerrillas. Thanks to the profitability of drug traffic, guerrillas, who initially were created based on ideologic differences, have become terrorist groups whose main source of income is drug traffic. From that interest comes the use of landmines to protect illicit crops. Colombia is the most mined country in the world, followed by Cambodia and Afghanistan, and the only country in Latin America where there are still landmines. The mines, violence, and trauma produce a large number of people with disabilities and amputations. From 1990 to 2006, the number of victims rose from 21 to 1,041 per year. In Colombia, amputations are more frequently due to trauma than to disease. The fact that 88% of the victims are children and people of working age, affects the political and economic development. These alarming numbers generate a challenge for government, which has led to the creation of policies and laws aimed at comprehensive action against mines. This program under the Presidency has among its objectives assistance to victims, including integrated treatment, prostheses, and other procedures, financed entirely by the government. The number, type of victims, and their motivation to be transplanted, along with government programs directed to their attention, are key factors that we think will enable the continuity of our hand transplantation program at the Fundación Santa Fe de Bogotá, giving Colombia the unfortunate privilege of having the largest number of potential patients for transplantation.
Assuntos
Traumatismos da Mão/terapia , Transplante de Mão , Transplante/métodos , Colômbia , Estudos de Viabilidade , Cirurgia Geral/economia , Geografia , Programas Governamentais , Traumatismos da Mão/cirurgia , Humanos , Desenvolvimento de Programas , Doadores de Tecidos , Obtenção de Tecidos e Órgãos , Transplante/economia , Transplante Homólogo , ViolênciaRESUMO
Este trabalho teve como objetivo identificar contribuições da área da terapia da mão para pessoas com paralisia cerebral, disponível na literatura bibliográfica nacional e internacional on-line, analisando a produção existente e verificando a existência de trabalhos estruturados. Configurou-se como sendo um estudo descritivo, retrospectivo, através critérios de revisão sistemática da literatura para coleta, seleção e análise dos dados. A busca foi realizada no período de fevereiro de 2010 a janeiro de 2011, nas bases de dados LILACS, MEDLINE, BIREME, SCOPUS e CINAHL, publicados em português e inglês, no período de 2003 a 2010. Onze artigos foram incluídos na revisão e utilizou-se um formulário elaborado pelas pesquisadoras para avaliá-los conforme a caracterização e qualidade das informações contidas. Os resultados evidenciaram que os assuntos com maior enfoque na amostra foram sobre intervenção ortótica, estimulação elétrica neuromuscular, toxina botulínica e função manual. Apesar de contribuírem com o conhecimento sobre intervenções na paralisia cerebral, os estudos não citam claramente os achados como contribuições da especialidade terapia da mão sobre o tema, e limitações metodológicas foram encontradas, inferindo-se a necessidade de maior rigor metodológico e qualidade das informações nos trabalhos científicos.
This study sought to identify the contributions of the hand therapy field to people with cerebral palsy, available in the domestic and international literature online, analyzing the existing works and verifying the existence of structured studies. It was configured as a descriptive, retrospective study, through the criteria of systematic review of the literature for the collection, selection, and analysis of data. The search was done from February of 2010 to January of 2011, on the LILACS, MEDLINE, BIREME, SCOPUS, and CINAHL databases, on works published in Portuguese and English, between 2003 and 2010. Eleven articles were included in the review and a form prepared by the researchers was used to evaluate these articles according to the haracterization and quality of the information contained. The results demonstrated that the most discussed subjects in the sample were orthotic intervention, neuromuscular electrical stimulation, botulinum toxin, and manual function. Despite contributing to knowledge on cerebral palsy interventions, the studies did not clearly mention the findings as contributions from the hand therapy specialty on the theme, and methodological limitations were found, implying the need for more methodological rigor and quality of information from the scientific studies.
Assuntos
Humanos , Masculino , Feminino , Paralisia Cerebral/complicações , Paralisia Cerebral/terapia , Traumatismos da Mão/reabilitação , Traumatismos da Mão/terapia , Epidemiologia Descritiva , Terapia OcupacionalRESUMO
OBJECTIVE: Determining the occupational exposure to biological fluids of medical technicians working in public clinical laboratories caused by accidental percutaneous contact, associated factors and compliance with post-exposure biological measures. METHODS: This was a descriptive cross-sectional study. The sample consisted of 156 medical technicians assigned to clinical laboratories in the metropolitan area of Zulia state in Venezuela. Data was collected by applying an instrument for exploring exposure and related factors, as well as compliance with established post-biological exposure measures. RESULTS: There was evidence of exposure caused by percutaneous accidents, mainly represented by a moderate level of needle-pricks and cuts (2-3.99 mean). There was a moderate level of factors regarding percutaneous injury in the hands and fingers associated with hollow needles, blood and blood products and superficial severity in sample taking and processing areas when recapping needles or handling sharp or cutting objects. A medium level (2-3.99 mean) of compliance was obtained for post-exposure handling. A significant correlation was found (p<001) between percutaneous exposure and level of compliance with post-exposure management. CONCLUSION: The magnitude and characteristics of exposure to biological fluids detected in this work represents a problematic situation which can affect staff health and must be approached by institutions to ensure effective prevention management and risk control.
Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Líquidos Corporais , Pessoal de Laboratório Médico , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Adulto , Técnicas de Laboratório Clínico/normas , Estudos Transversais , Feminino , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/terapia , Humanos , Lacerações/epidemiologia , Lacerações/terapia , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/terapia , Gestão de Riscos , Gestão da Segurança/normas , Absorção Cutânea , Venezuela/epidemiologia , Infecção dos Ferimentos/prevenção & controle , Ferimentos não Penetrantes/epidemiologia , Ferimentos não Penetrantes/terapia , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/terapia , Adulto JovemRESUMO
Objetivo Determinar la exposición laboral accidental a fluidos biológicos por contacto percutáneo en el personal Bioanalista de Laboratorios Clínicos públicos, sus factores asociados y el cumplimiento de medidas post exposición biológica. Métodos Se realizó un estudio descriptivo transversal, la muestra fue de 156 bioanalistas adscritos a laboratorios clínicos del área metropolitana del estado Zulia. Para la recolección de datos se aplicó un instrumento de escalas que exploró la exposición percutánea, los factores vinculados y el cumplimiento de medidas post exposición biológica. Resultados Se evidenció exposición por accidentes percutáneos, representados principalmente por pinchazos y cortaduras, detectados en razón de su ocurrencia en un nivel moderado (media entre 2-3,99). Como factores vinculados a la accidentabilidad percutánea, se registra la ocurrencia en nivel moderado con diversas agujas huecas, con sangre y hemoderivados, en manos y dedos, con una severidad superficial, en áreas de toma y procesamiento de muestras durante el re-encapuchado de objetos punzo cortantes. Un nivel de mediano cumplimiento se obtuvo para el manejo post exposición. Existe relación entre la exposición percutánea con el nivel de cumplimiento detectado para el manejo post exposición p <0,001. Conclusión La magnitud y características de la exposición a fluidos biológicos detectada en este colectivo laboral reviste una problemática que puede impactar en la salud del personal y debe ser abordada institucionalmente para una efectiva gestión de prevención y control de riesgo.
Objective Determining the occupational exposure to biological fluids of medical technicians working in public clinical laboratories caused by accidental percutaneous contact, associated factors and compliance with post-exposure biological measures. Methods This was a descriptive cross-sectional study. The sample consisted of 156 medical technicians assigned to clinical laboratories in the metropolitan area of Zulia state in Venezuela. Data was collected by applying an instrument for exploring exposure and related factors, as well as compliance with established post-biological exposure measures. Results There was evidence of exposure caused by percutaneous accidents, mainly represented by a moderate level of needle-pricks and cuts (2-3.99 mean). There was a moderate level of factors regarding percutaneous injury in the hands and fingers associated with hollow needles, blood and blood products and superficial severity in sample taking and processing areas when recapping needles or handling sharp or cutting objects. A medium level (2-3.99 mean) of compliance was obtained for post-exposure handling. A significant correlation was found (p<001) between percutaneous exposure and level of compliance with post-exposure management. Conclusion The magnitude and characteristics of exposure to biological fluids detected in this work represents a problematic situation which can affect staff health and must be approached by institutions to ensure effective prevention management and risk control.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Acidentes de Trabalho/estatística & dados numéricos , Líquidos Corporais , Pessoal de Laboratório , Ferimentos Penetrantes Produzidos por Agulha/epidemiologia , Técnicas de Laboratório Clínico/normas , Estudos Transversais , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/terapia , Lacerações/epidemiologia , Lacerações/terapia , Ferimentos Penetrantes Produzidos por Agulha/terapia , Gestão de Riscos , Gestão da Segurança/normas , Absorção Cutânea , Venezuela/epidemiologia , Infecção dos Ferimentos/prevenção & controle , Ferimentos não Penetrantes/epidemiologia , Ferimentos não Penetrantes/terapia , Ferimentos Penetrantes/epidemiologia , Ferimentos Penetrantes/terapia , Adulto JovemRESUMO
Every year 10 to 20 cases of snake bites are reported on the Caribbean island of Martinique. The only snake involved, Bothrops lanceolatus, is endemic on the island, and its bite may lead to systemic multifocal thrombotic complications in the'absence of the monospecific antivenom. Between January 1988 and January 2009, more than 250 snake bites have been reported, and five patients were treated with hyperbaric oxygen (HBO2) therapy for local complications. The patients were male, bitten on the leg or the hand, and presented with severe complications such as necrotizing soft tissue infections, compartment syndrome or abscesses despite prompt wound care and administration of antivenomous serum. Outcomes were favorable for these five patients, except for one who was left with a functional defect of the hand. Although snake bites are not part of the currently recommended indications for HBO2 therapy, local complications, namely compartment syndrome, necrotizing soft tissue infections and enhancement of healing in selected problem wounds, are approved uses of HBO2 therapy as defined by the Hyperbaric Oxygen Therapy Committee and would benefit from prospective studies.