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Abstract
CONTEXT
It is not clear if an oral hygiene protocol to control biofilm applied before cardiac surgery can reduce infection rates.
OBJECTIVE
We aim to verify the effectiveness of an oral hygiene protocol in reducing postoperative infections when compared to usual practices, in patients admitted to a cardiology unit, prior to cardiac surgery.
DESIGN, SETTING AND PARTICIPANTS
Randomized, blind, controlled clinical trial, with 107 participants who expected to undergo cardiac surgery, randomized into two groups: Experimental Group (EG) standardized oral hygiene protocol (54) and Control Group (CG), usual practices performed in patients admitted (53).
INTERVENTION
a standardized oral hygiene protocol, 1 day before surgery: professional prophylaxis with a portable ultrasound device, tooth brushing and flossing plus a 0.12% chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When applicable, removable prostheses cleaning.
PRIMARY OUTCOME
the presence of infection.
RESULTS
The occurrence of postoperative infection was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical difference was found between protocols (p = 0.518). The length of stayed from surgery to discharge presented a statistical difference (p = 0.047; RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was almost five times higher in those participants who stayed 11 or more days.
CONCLUSION
The standardized oral hygiene protocol with mechanical and chemical cleaning, 1 day before cardiac surgery, was not more effective than the usual practices performed regarding the reduction of postoperative infections. Other interventions regarding oral hygiene procedures before cardiac surgery must be studied to contribute to the reduction of adverse post-surgical events.
CLINICAL TRIAL REGISTRATION
Site Ensaclinicos.gov.br number U1111-1214-2862.
DESCRIPTORS
Healthcare Associated Infections, Cardiovascular Diseases, Periodontal Diseases, Dental Biofilm, Cardiovascular Surgery.
Authors+Show Affiliations
Federal University of Santa Catarina, Florianópolis, Brazil.
Federal University of Santa Catarina, Florianópolis, Brazil.
Federal University of Santa Catarina, Florianópolis, Brazil.
Federal University of Santa Catarina, Florianópolis, Brazil.
Universidad de Granada, Granada, Spain.
Federal University of Santa Catarina, Florianópolis, Brazil.
MeSH
HumansOral HygieneChlorhexidineMouthwashesToothbrushingCardiac Surgical ProceduresPostoperative Complications
Pub Type(s)
Randomized Controlled Trial
Journal Article
Language
eng
PubMed ID
36546871
Citation
Núñez, María Del Rosario Ruiz, et al. "Oral Hygiene Prior to Cardiac Surgery to Prevent Infections: Randomized Clinical Trial." International Journal of Dental Hygiene, vol. 22, no. 2, 2024, pp. 384-393.
Núñez MDRR, Engel FD, Cardoso M, et al. Oral hygiene prior to cardiac surgery to prevent infections: Randomized clinical trial. Int J Dent Hyg. 2024;22(2):384-393.
Núñez, M. D. R. R., Engel, F. D., Cardoso, M., Castro, R. G., Montoya, J. A. G., & de Mello, A. L. S. F. (2024). Oral hygiene prior to cardiac surgery to prevent infections: Randomized clinical trial. International Journal of Dental Hygiene, 22(2), 384-393. https://doi.org/10.1111/idh.12661
Núñez MDRR, et al. Oral Hygiene Prior to Cardiac Surgery to Prevent Infections: Randomized Clinical Trial. Int J Dent Hyg. 2024;22(2):384-393. PubMed PMID: 36546871.
* Article titles in AMA citation format should be in sentence-case
TY - JOURT1 - Oral hygiene prior to cardiac surgery to prevent infections: Randomized clinical trial.AU - Núñez,María Del Rosario Ruiz,AU - Engel,Franciely Daiana,AU - Cardoso,Mariane,AU - Castro,Renata Goulart,AU - Montoya,José Antonio Gil,AU - de Mello,Ana Lúcia Schaefer Ferreira,Y1 - 2022/12/31/PY - 2022/12/14/revisedPY - 2021/12/10/receivedPY - 2022/12/19/acceptedPY - 2024/4/8/medlinePY - 2022/12/23/pubmedPY - 2022/12/22/entrezSP - 384EP - 393JF - International journal of dental hygieneJO - Int J Dent HygVL - 22IS - 2N2 - CONTEXT: It is not clear if an oral hygiene protocol to control biofilm applied before cardiac surgery can reduce infection rates. OBJECTIVE: We aim to verify the effectiveness of an oral hygiene protocol in reducing postoperative infections when compared to usual practices, in patients admitted to a cardiology unit, prior to cardiac surgery. DESIGN, SETTING AND PARTICIPANTS: Randomized, blind, controlled clinical trial, with 107 participants who expected to undergo cardiac surgery, randomized into two groups: Experimental Group (EG) standardized oral hygiene protocol (54) and Control Group (CG), usual practices performed in patients admitted (53). INTERVENTION: a standardized oral hygiene protocol, 1 day before surgery: professional prophylaxis with a portable ultrasound device, tooth brushing and flossing plus a 0.12% chlorhexidine gluconate solution (0.12% CHX) mouth rinsing. When applicable, removable prostheses cleaning. PRIMARY OUTCOME: the presence of infection. RESULTS: The occurrence of postoperative infection was higher in CG = 7 (13.2%) than in EG = 5 (9.3%); but no statistical difference was found between protocols (p = 0.518). The length of stayed from surgery to discharge presented a statistical difference (p = 0.047; RR = 4.9; CI = 1.01-24.33); the percentage of postoperative infection was almost five times higher in those participants who stayed 11 or more days. CONCLUSION: The standardized oral hygiene protocol with mechanical and chemical cleaning, 1 day before cardiac surgery, was not more effective than the usual practices performed regarding the reduction of postoperative infections. Other interventions regarding oral hygiene procedures before cardiac surgery must be studied to contribute to the reduction of adverse post-surgical events. CLINICAL TRIAL REGISTRATION: Site Ensaclinicos.gov.br number U1111-1214-2862. DESCRIPTORS: Healthcare Associated Infections, Cardiovascular Diseases, Periodontal Diseases, Dental Biofilm, Cardiovascular Surgery. SN - 1601-5037UR - https://www.unboundmedicine.com/medline/citation/36546871/Oral_Hygiene_Prior_to_Cardiac_Surgery_to_Prevent_Infections:_Randomized_Clinical_Trial.DB - PRIMEDP - Unbound MedicineER -