RISK FACTORS FOR SURGICAL WOUND INFECTION AFTER ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY

ABSTRACT - BACKGROUND: One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although curr...

Full description

Saved in:
Bibliographic Details
Published in:Arquivos brasileiros de cirurgia digestiva : ABCD Vol. 35
Main Authors: GAMO, Gustavo de Oliveira, REICHARDT, Gabriel Sebben, GUETTER, Camila Roginski, PIMENTEL, Silvania Klug
Format: Journal Article
Language:English
Published: Colégio Brasileiro de Cirurgia Digestiva 01-01-2022
Subjects:
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Abstract ABSTRACT - BACKGROUND: One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any advantage of this practice in the absence of risk factors. AIM: This study aimed to evaluate the incidence of wound infection after elective laparoscopic cholecystectomies and the use of antibiotic prophylaxis in these procedures. METHODS: This is a retrospective study of 439 patients with chronic cholecystitis and cholelithiasis, accounting for different risk factors for wound infection. RESULTS: There were 7 (1.59%) cases of wound infection. No antibiotic prophylaxis regimen significantly altered infection rates. There was a statistically significant correlation between wound infection and male patients (p=0.013). No other analyzed risk factor showed a statistical correlation with wound infection. CONCLUSIONS: The non-use of antibiotic prophylaxis and other analyzed factors did not present a significant correlation for the increase in the occurrence of wound infection. Studies with a larger sample and a control group without antibiotic prophylaxis are necessary. RESUMO - RACIONAL: Uma das formas de evitar infecção após procedimentos cirúrgicos é por meio de profilaxia antibiótica. Isso ocorre em colecistectomias com certos fatores de risco para infecção. No entanto, algumas diretrizes sugerem o uso de profilaxia antibiótica para todas as colecistectomias, embora evidências atuais não indiquem qualquer benefício dessa prática na ausência de fatores de risco. OBJETIVO: Avaliar a incidência de infecção em ferida operatória após colecistectomias laparoscópicas eletivas e o uso de antibioticoprofilaxia nesses procedimentos. MÉTODOS: Estudo retrospectivo de 439 pacientes com colecistite crônica e colelitíase, contabilizados os diferentes fatores de risco para infecção de feridas. RESULTADOS: Ocorreram sete casos de infecção de ferida operatória (1.59%). Nenhum esquema de antibioticoprofilaxia alterou significativamente as taxas de infecção. Foi registrada correlação estatisticamente significativa entre infecção de ferida operatória e pacientes do sexo masculino (p=0.013). Nenhum outro fator de risco analisado demonstrou correlação estatística com infecção de ferida operatória. CONCLUSÕES: O não emprego de antibioticoprofilaxia e outros fatores analisados não apresentaram correlação significativa para aumento da frequência de infecção de ferida operatória. Estudos com maior amostra e grupo controle sem antibioticoprofilaxia são necessários.
AbstractList ABSTRACT - BACKGROUND: One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any advantage of this practice in the absence of risk factors. AIM: This study aimed to evaluate the incidence of wound infection after elective laparoscopic cholecystectomies and the use of antibiotic prophylaxis in these procedures. METHODS: This is a retrospective study of 439 patients with chronic cholecystitis and cholelithiasis, accounting for different risk factors for wound infection. RESULTS: There were 7 (1.59%) cases of wound infection. No antibiotic prophylaxis regimen significantly altered infection rates. There was a statistically significant correlation between wound infection and male patients (p=0.013). No other analyzed risk factor showed a statistical correlation with wound infection. CONCLUSIONS: The non-use of antibiotic prophylaxis and other analyzed factors did not present a significant correlation for the increase in the occurrence of wound infection. Studies with a larger sample and a control group without antibiotic prophylaxis are necessary. RESUMO - RACIONAL: Uma das formas de evitar infecção após procedimentos cirúrgicos é por meio de profilaxia antibiótica. Isso ocorre em colecistectomias com certos fatores de risco para infecção. No entanto, algumas diretrizes sugerem o uso de profilaxia antibiótica para todas as colecistectomias, embora evidências atuais não indiquem qualquer benefício dessa prática na ausência de fatores de risco. OBJETIVO: Avaliar a incidência de infecção em ferida operatória após colecistectomias laparoscópicas eletivas e o uso de antibioticoprofilaxia nesses procedimentos. MÉTODOS: Estudo retrospectivo de 439 pacientes com colecistite crônica e colelitíase, contabilizados os diferentes fatores de risco para infecção de feridas. RESULTADOS: Ocorreram sete casos de infecção de ferida operatória (1.59%). Nenhum esquema de antibioticoprofilaxia alterou significativamente as taxas de infecção. Foi registrada correlação estatisticamente significativa entre infecção de ferida operatória e pacientes do sexo masculino (p=0.013). Nenhum outro fator de risco analisado demonstrou correlação estatística com infecção de ferida operatória. CONCLUSÕES: O não emprego de antibioticoprofilaxia e outros fatores analisados não apresentaram correlação significativa para aumento da frequência de infecção de ferida operatória. Estudos com maior amostra e grupo controle sem antibioticoprofilaxia são necessários.
One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for infection. However, some guidelines suggest the use of antibiotic prophylaxis for all cholecystectomies, although current evidence does not indicate any advantage of this practice in the absence of risk factors.
Author GAMO, Gustavo de Oliveira
PIMENTEL, Silvania Klug
GUETTER, Camila Roginski
REICHARDT, Gabriel Sebben
Author_xml – sequence: 1
  givenname: Gustavo de Oliveira
  orcidid: 0000-0002-9615-9280
  surname: GAMO
  fullname: GAMO, Gustavo de Oliveira
  organization: Federal University of Parana, Brazil
– sequence: 2
  givenname: Gabriel Sebben
  orcidid: 0000-0003-0188-7857
  surname: REICHARDT
  fullname: REICHARDT, Gabriel Sebben
  organization: Federal University of Parana, Brazil
– sequence: 3
  givenname: Camila Roginski
  orcidid: 0000-0002-7918-4580
  surname: GUETTER
  fullname: GUETTER, Camila Roginski
  organization: Federal University of Parana, Brazil
– sequence: 4
  givenname: Silvania Klug
  orcidid: 0000-0002-4232-4279
  surname: PIMENTEL
  fullname: PIMENTEL, Silvania Klug
  organization: Federal University of Parana, Brazil
BookMark eNplkN1Kw0AQhRep2Fr7CrIvEN3_TW6EEBMbjN2SH6VXyybdaKVNS1IF397USkFkLoaZc-aDOZdg0GwbC8A1RjeYe-gWYUQcIQnqCyOEiMWC8zMwIhRLR1AiBmB0Mg3BpOveexuiHmKevABDyiVFrstGoEjj7BFGfpCrNIORSmFWpA9x4CfwRRWzexjPojDIYzWDfpSHKQyTw_gcwsSf-6nKAjWPAxhMVb9fZHkvqqfFFTivzbqzk98-BkUU5sHUSdQP26kYRXtHENcYl9eiFpaWrGSe4VZazgmTVW1qV6LSuERIavtXOTGeZUTgslrWS0Y8S8fg7sjdfZQbu6xss2_NWu_a1ca0X3prVvqv0qze9Ov2U3uEM45xDxBHQNVuu6619ekWI33IWh9i1P-ypt-gx2ub
CitedBy_id crossref_primary_10_1007_s00261_024_04387_5
crossref_primary_10_22141_2224_0586_20_2_2024_1668
Cites_doi 10.1089/sur.2016.265
10.1089/lap.2010.0436
10.1089/sur.2018.195
10.1590/S0100-69912014000300003
10.1111/ases.12348
10.1007/s00268-017-4018-3
10.1007/s11605-018-3739-4
10.1111/j.1758-5910.2012.00152.x
10.1093/ofid/ofx036
10.1016/j.jss.2019.09.038
10.1016/j.jamcollsurg.2017.11.025
10.21037/tgh.2018.04.06
10.1089/lap.2020.0322
10.1590/0102-6720201600030010
10.19082/2308
10.1016/j.ddtec.2014.02.001
10.1002/bjs.9904
10.1177/000313481808400434
10.1308/rcsann.2017.0001
10.2146/ajhp120568
10.1136/bmjopen-2017-016666
10.14701/kjhbps.2015.19.4.188
10.1111/iwj.13175
10.1111/jgh.13246
10.1089/sur.2008.084
ContentType Journal Article
DBID AAYXX
CITATION
5PM
DOI 10.1590/0102-672020210002e1655
DatabaseName CrossRef
PubMed Central (Full Participant titles)
DatabaseTitle CrossRef
DatabaseTitleList CrossRef

DeliveryMethod fulltext_linktorsrc
EISSN 2317-6326
ExternalDocumentID 10_1590_0102_672020210002e1655
GroupedDBID ---
53G
5VS
AAFWJ
AAYXX
ABXHO
ADBBV
ADRAZ
AFPKN
ALMA_UNASSIGNED_HOLDINGS
AOIJS
APOWU
AZFZN
BAWUL
BCNDV
CITATION
DIK
GROUPED_DOAJ
GX1
HYE
IPNFZ
KQ8
M48
OK1
PGMZT
RIG
RNS
RPM
RSC
SCD
5PM
ID FETCH-LOGICAL-c430t-628aa85f6f6e3b4b49a5e7e55247cfaf870ba82673e02052a9e4261bcdfd429e3
IEDL.DBID RPM
ISSN 0102-6720
IngestDate Tue Sep 17 21:06:20 EDT 2024
Fri Aug 23 03:36:03 EDT 2024
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Language English
License This is an open-access article distributed under the terms of the Creative Commons Attribution License
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c430t-628aa85f6f6e3b4b49a5e7e55247cfaf870ba82673e02052a9e4261bcdfd429e3
Notes Conflict of interest: none
ORCID 0000-0002-9615-9280
0000-0002-7918-4580
0000-0002-4232-4279
0000-0003-0188-7857
OpenAccessLink https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9254511/
PMID 35730884
ParticipantIDs pubmedcentral_primary_oai_pubmedcentral_nih_gov_9254511
crossref_primary_10_1590_0102_672020210002e1655
PublicationCentury 2000
PublicationDate 2022-01-01
PublicationDateYYYYMMDD 2022-01-01
PublicationDate_xml – month: 01
  year: 2022
  text: 2022-01-01
  day: 01
PublicationDecade 2020
PublicationTitle Arquivos brasileiros de cirurgia digestiva : ABCD
PublicationYear 2022
Publisher Colégio Brasileiro de Cirurgia Digestiva
Publisher_xml – name: Colégio Brasileiro de Cirurgia Digestiva
References Macano C (ref15) 2017; 99
Claus CMP (ref3) 2021; 34
Matsui Y (ref17) 2018; 8
Gomez-Ospina JC (ref7) 2018; 22
Karabulut Z (ref12) 2021; 31
Darzi AA (ref5) 2016; 8
Kamran K (ref11) 2013; 6
(ref9) 2017
Santana RS (ref25) 2014; 41
Martinez JL (ref16) 2014; 11
van Dijk AH (ref30) 2019; 20
Yan RC (ref33) 2011; 21
Sajid MS (ref23) 2018; 3
Sanabria A (ref24) 2010
Costa ACD (ref4) 2021; 33
Jain N (ref10) 2015; 2015
Passos MA (ref20) 2016; 29
Ely S (ref6) 2020; 246
Liang B (ref14) 2016; 31
Smith JP (ref28) 2018; 84
Rodríguez-Caravaca G (ref22) 2017; 69
Sharma N (ref27) 2010; 11
Kharga B (ref13) 2016; 10
Chong JU (ref2) 2015; 19
Sarkut P (ref26) 2017; 18
(ref18) 2004
Warren DK (ref32) 2017; 4
Bratzler DW (ref1) 2013; 70
Peponis T (ref21) 2018; 226
Vohra RS (ref31) 2017; 41
Pasquali S (ref19) 2016; 103
Usuba T (ref29) 2017; 10
Guler Y (ref8) 2019; 16
References_xml – volume: 18
  start-page: 603
  issue: 5
  year: 2017
  ident: ref26
  article-title: Routine Use of Prophylactic Antibiotics during Laparoscopic Cholecystectomy Does Not Reduce the Risk of Surgical Site Infections
  publication-title: Surg Infect (Larchmt)
  doi: 10.1089/sur.2016.265
  contributor:
    fullname: Sarkut P
– volume: 21
  start-page: 301
  issue: 4
  year: 2011
  ident: ref33
  article-title: The role of prophylactic antibiotics in laparoscopic cholecystectomy in preventing postoperative infection: a meta-analysis
  publication-title: J Laparoendosc Adv Surg Tech A
  doi: 10.1089/lap.2010.0436
  contributor:
    fullname: Yan RC
– volume: 20
  start-page: 298
  issue: 4
  year: 2019
  ident: ref30
  article-title: Efficacy of Antibiotic Agents after Spill of Bile and Gallstones during Laparoscopic Cholecystectomy
  publication-title: Surg Infect (Larchmt)
  doi: 10.1089/sur.2018.195
  contributor:
    fullname: van Dijk AH
– volume: 41
  start-page: 149
  issue: 3
  year: 2014
  ident: ref25
  article-title: The cost of excessive postoperative use of antimicrobials: the context of a public hospital
  publication-title: Rev Col Bras Cir
  doi: 10.1590/S0100-69912014000300003
  contributor:
    fullname: Santana RS
– volume: 34
  issue: 2
  year: 2021
  ident: ref3
  article-title: Simultaneous laparoscopic inguinal hernia repair and cholecystectomy: does it cause mesh infection?
  publication-title: Arq Bras Cir Dig
  contributor:
    fullname: Claus CMP
– volume: 10
  start-page: 162
  issue: 2
  year: 2017
  ident: ref29
  article-title: Clinical outcomes of laparoscopic cholecystectomy with accidental gallbladder perforation
  publication-title: Asian J Endosc Surg
  doi: 10.1111/ases.12348
  contributor:
    fullname: Usuba T
– volume: 41
  start-page: 2231
  issue: 9
  year: 2017
  ident: ref31
  article-title: Effectiveness of Antibiotic Prophylaxis in Non-emergency Cholecystectomy Using Data from a Population-Based Cohort Study
  publication-title: World J Surg
  doi: 10.1007/s00268-017-4018-3
  contributor:
    fullname: Vohra RS
– volume: 22
  start-page: 1193
  issue: 7
  year: 2018
  ident: ref7
  article-title: Antibiotic Prophylaxis in Elective Laparoscopic Cholecystectomy: a Systematic Review and Network Meta-Analysis
  publication-title: J Gastrointest Surg
  doi: 10.1007/s11605-018-3739-4
  contributor:
    fullname: Gomez-Ospina JC
– volume: 6
  start-page: 21
  issue: 1
  year: 2013
  ident: ref11
  article-title: Does sex affect the outcome of laparoscopic cholecystectomy? A retrospective analysis of single center experience
  publication-title: Asian J Endosc Surg
  doi: 10.1111/j.1758-5910.2012.00152.x
  contributor:
    fullname: Kamran K
– start-page: 11
  year: 2017
  ident: ref9
– year: 2004
  ident: ref18
– volume: 4
  start-page: ofx036
  issue: 2
  year: 2017
  ident: ref32
  article-title: Risk Factors for Surgical Site Infection After Cholecystectomy
  publication-title: Open Forum Infect Dis
  doi: 10.1093/ofid/ofx036
  contributor:
    fullname: Warren DK
– volume: 246
  start-page: 506
  year: 2020
  ident: ref6
  article-title: Modern Elective Laparoscopic Cholecystectomy Carries Extremely Low Postoperative Infection Risk
  publication-title: J Surg Res
  doi: 10.1016/j.jss.2019.09.038
  contributor:
    fullname: Ely S
– volume: 2015
  start-page: 204508
  year: 2015
  ident: ref10
  article-title: Relationship of Gallbladder Perforation and Bacteriobilia with Occurrence of Surgical Site Infections following Laparoscopic Cholecystectomy
  publication-title: Minim Invasive Surg
  contributor:
    fullname: Jain N
– volume: 226
  start-page: 1030
  issue: 6
  year: 2018
  ident: ref21
  article-title: Bile Spillage as a Risk Factor for Surgical Site Infection after Laparoscopic Cholecystectomy: A Prospective Study of 1,001 Patients
  publication-title: J Am Coll Surg
  doi: 10.1016/j.jamcollsurg.2017.11.025
  contributor:
    fullname: Peponis T
– volume: 3
  start-page: 22
  year: 2018
  ident: ref23
  article-title: Prophylactic antibiotics at the time of elective cholecystectomy are effective in reducing the post-operative infective complications: a systematic review and meta-analysis
  publication-title: Transl Gastroenterol Hepatol
  doi: 10.21037/tgh.2018.04.06
  contributor:
    fullname: Sajid MS
– volume: 31
  start-page: 54
  issue: 1
  year: 2021
  ident: ref12
  article-title: What Should be Done for Perforation of the Gallbladder During Laparoscopic Cholecystectomy: Prophylaxis or Treatment?
  publication-title: J Laparoendosc Adv Surg Tech A
  doi: 10.1089/lap.2020.0322
  contributor:
    fullname: Karabulut Z
– volume: 29
  start-page: 170
  issue: 3
  year: 2016
  ident: ref20
  article-title: Antibiotic prophylaxis in laparoscopic cholecistectomy: is it worth doing?
  publication-title: Arq Bras Cir Dig
  doi: 10.1590/0102-6720201600030010
  contributor:
    fullname: Passos MA
– volume: 8
  start-page: 2308
  issue: 5
  year: 2016
  ident: ref5
  article-title: The Effect of Prophylactic Antibiotics on Post Laparoscopic Cholecystectomy Infectious Complications: A Double-Blinded Clinical Trial
  publication-title: Electron Physician
  doi: 10.19082/2308
  contributor:
    fullname: Darzi AA
– volume: 11
  start-page: 33
  year: 2014
  ident: ref16
  article-title: General principles of antibiotic resistance in bacteria
  publication-title: Drug Discovery Today: Technologies
  doi: 10.1016/j.ddtec.2014.02.001
  contributor:
    fullname: Martinez JL
– volume: 103
  start-page: 27
  issue: 1
  year: 2016
  ident: ref19
  article-title: Meta-analysis of perioperative antibiotics in patients undergoing laparoscopic cholecystectomy
  publication-title: Br J Surg
  doi: 10.1002/bjs.9904
  contributor:
    fullname: Pasquali S
– start-page: CD005265
  issue: 12
  year: 2010
  ident: ref24
  article-title: Antibiotic prophylaxis for patients undergoing elective laparoscopic cholecystectomy
  publication-title: Cochrane Database Syst Rev
  contributor:
    fullname: Sanabria A
– volume: 10
  start-page: PC28
  issue: 10
  year: 2016
  ident: ref13
  article-title: Obesity Not Necessary, Risk of Symptomatic Cholelithiasis Increases as a Function of BMI
  publication-title: J Clin Diagn Res
  contributor:
    fullname: Kharga B
– volume: 69
  start-page: 336
  issue: 6
  year: 2017
  ident: ref22
  article-title: Rates of Surgical Site Infection in Cholecystectomy: Comparison between a University Teaching Hospital, Madrid Region, Spain, and USA Rates
  publication-title: Rev Invest Clin
  contributor:
    fullname: Rodríguez-Caravaca G
– volume: 84
  start-page: 576
  issue: 4
  year: 2018
  ident: ref28
  article-title: Prophylactic Antibiotics for Elective Laparoscopic Cholecystectomy
  publication-title: Am Surg
  doi: 10.1177/000313481808400434
  contributor:
    fullname: Smith JP
– volume: 33
  issue: 4
  year: 2021
  ident: ref4
  article-title: What’s new in infection on surgical site and antibioticoprophylaxis in surgery?
  publication-title: Arq Bras Cir Dig
  contributor:
    fullname: Costa ACD
– volume: 99
  start-page: 216
  issue: 3
  year: 2017
  ident: ref15
  article-title: Current practice of antibiotic prophylaxis during elective laparoscopic cholecystectomy
  publication-title: Ann R Coll Surg Engl
  doi: 10.1308/rcsann.2017.0001
  contributor:
    fullname: Macano C
– volume: 70
  start-page: 195
  issue: 3
  year: 2013
  ident: ref1
  article-title: Clinical practice guidelines for antimicrobial prophylaxis in surgery
  publication-title: Am J Health Syst Pharm
  doi: 10.2146/ajhp120568
  contributor:
    fullname: Bratzler DW
– volume: 8
  issue: 3
  year: 2018
  ident: ref17
  article-title: Reappraisal of previously reported meta-analyses on antibiotic prophylaxis for low-risk laparoscopic cholecystectomy: an overview of systematic reviews
  publication-title: BMJ Open
  doi: 10.1136/bmjopen-2017-016666
  contributor:
    fullname: Matsui Y
– volume: 19
  start-page: 188
  issue: 4
  year: 2015
  ident: ref2
  article-title: The role of prophylactic antibiotics on surgical site infection in elective laparoscopic cholecystectomy
  publication-title: Korean J Hepatobiliary Pancreat Surg
  doi: 10.14701/kjhbps.2015.19.4.188
  contributor:
    fullname: Chong JU
– volume: 16
  start-page: 1164
  issue: 5
  year: 2019
  ident: ref8
  article-title: The effect of antibiotic prophylaxis on wound infections after laparoscopic cholecystectomy: A randomised clinical trial
  publication-title: Int Wound J
  doi: 10.1111/iwj.13175
  contributor:
    fullname: Guler Y
– volume: 31
  start-page: 921
  issue: 5
  year: 2016
  ident: ref14
  article-title: Safety and efficacy of antibiotic prophylaxis in patients undergoing elective laparoscopic cholecystectomy: A systematic review and meta-analysis
  publication-title: J Gastroenterol Hepatol
  doi: 10.1111/jgh.13246
  contributor:
    fullname: Liang B
– volume: 11
  start-page: 367
  issue: 4
  year: 2010
  ident: ref27
  article-title: Role of prophylactic antibiotics in laparoscopic cholecystectomy and risk factors for surgical site infection: a randomized controlled trial
  publication-title: Surg Infect (Larchmt)
  doi: 10.1089/sur.2008.084
  contributor:
    fullname: Sharma N
SSID ssj0000390497
Score 2.254915
Snippet ABSTRACT - BACKGROUND: One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with...
One of the ways to avoid infection after surgical procedures is through antibiotic prophylaxis. This occurs in cholecystectomies with certain risk factors for...
SourceID pubmedcentral
crossref
SourceType Open Access Repository
Aggregation Database
SubjectTerms Original
Title RISK FACTORS FOR SURGICAL WOUND INFECTION AFTER ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY
URI https://pubmed.ncbi.nlm.nih.gov/PMC9254511
Volume 35
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JTsMwELUoJy4IBIiyVD5wDdm8xMcoTUQFNFXTAj1ViReBBAFB-_-M3RZRceMYW5bi52XmJfNmELoitTE81MRTzEpyeKw80TDtaUlEUxsSqsDqnW8qPnxK-rlNk0M3WhgXtC-bl-v29e26fXl2sZUfb9LfxIn5o_tMAKsBR8HvoA74hr8ourt-gcUTsZJJw2lnPArWymAqAv-nLbJkB64DHTJqy9fEFPZ6kpAt-7QdJ_nL8BQHaH_tMeJ09WaHaEe3R2g6HlS3uEizSTmuMDA5XE3HrqoBfiynwz4eDIvcxYfgtACPFed39vEhx3fpKB2XVVaOBhm2_5HybFZNoLO8nx2jaZFPshtvXSHBkyQOFh6LkrpOqGGG6bghDRE11VxTGhEuTW3gMDY1EAgea5gwjWqhLWVqpDIKDJGOT9Bu-97qU4RlYASXjBEFTopSJNGJCCMuGxozEgraRf4Gl_nHKhHG3BIIAHVuQZ3_AbWL-BZ8P8NsRuvtHlhol9l6vbBn_x55jvYiq09w30gu0O7ic6kvUedLLXuObffcXvkG42a41Q
link.rule.ids 230,315,729,782,786,866,887,27933,27934,53800,53802
linkProvider National Library of Medicine
linkToHtml http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV3JTsMwELVYDnBhESB2fOAasnmJj1FI1Iq2qZqW5RQlXgQSBATt_zNOW0TFjWMysmTNeDzzknkzCF2Tyhjua-IoZik5PFSOqJl2tCSirgzxlWf5zp2CDx6j29S2yaFLLkxbtC_rl5vm9e2meXluays_3qS7rBNzh_1EAKqBRMFdR5vgr573C6S3FzDgeCLmRGnwd8YDb8ENpsJzf94FFu7AhaB9Ru0Am5DCaY8ishKhVislf4WebPefm95DO4tcE8dz8T5a080Bmoy6xR3O4mScjwoMGBAXk1E7DwE_5JPBLe4OsrStLMFxBrkuTnv28T7FvXgYj_IiyYfdBNs_UGnyVIxBmPefDtEkS8dJx1nMVnAkCb2pw4KoqiJqmGE6rElNREU115QGhEtTGXDjugLowUMNiqJBJbQFW7VURkEI0-ER2mjeG32MsPSM4JIxoiC9UYpEOhJ-wGVNQ0Z8QU-Qu9Rn-TFvoVFa6AHGKK0xyj_GOEF8Re0_y2wv7FUJaLvtib3Q7um_V16hrc643yt73cHdGdoOLMuh_dJyjjamnzN9gda_1OyyPWnf1-vNYw
linkToPdf http://sdu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV3JTsMwELVYJMSFRYDY8YFryOYlPkZpIipKUzUtyylKvIhKECqW_2ecloqKGxxjx5L1xuOZl8yC0CWpjOG-Jo5iNiWHh8oRNdOOlkTUlSG-8my-83XB-w9RJ7VlchatvtqgfVlPrprnl6tm8tTGVk5fpPsdJ-YObhMBrAYcBXeqjLuK1kFnveAHUW8vYeDyRMySpUHnGQ-8eX4wFZ67GAss5YFLQfuM2iY2IYUTH0VkyUotR0v-MD_Z9j82voO25j4njmev7KIV3eyh8bBb3OAsTkb5sMDABXExHrZ9EfB9Pu53cLefpW2ECY4z8Hlx2rOPdynuxYN4mBdJPugm2P6JSpPHYgST-e3jPhpn6Si5duY9FhxJQu_DYUFUVRE1zDAd1qQmoqKaa0oDwqWpDKhzXQEF4aEGsGhQCW1JVy2VUWDKdHiA1prXRh8iLD0juGSMKHBzlCKRjoQfcFnTkBFf0CPkfmNaTmelNEpLQUAgpRVI-UsgR4gvQb9YZmtiL88A4m1t7DnCx39eeYE2Bp2s7HX7NydoM7DJDu0Hl1O09vH2qc_Q6rv6PG8P2xfEJc_j
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=RISK+FACTORS+FOR+SURGICAL+WOUND+INFECTION+AFTER+ELECTIVE+LAPAROSCOPIC+CHOLECYSTECTOMY&rft.jtitle=Arquivos+brasileiros+de+cirurgia+digestiva+%3A+ABCD&rft.au=GAMO%2C+Gustavo+de+Oliveira&rft.au=REICHARDT%2C+Gabriel+Sebben&rft.au=GUETTER%2C+Camila+Roginski&rft.au=PIMENTEL%2C+Silvania+Klug&rft.date=2022-01-01&rft.pub=Col%C3%A9gio+Brasileiro+de+Cirurgia+Digestiva&rft.issn=0102-6720&rft.eissn=2317-6326&rft.volume=35&rft_id=info:doi/10.1590%2F0102-672020210002e1655&rft_id=info%3Apmid%2F35730884&rft.externalDBID=PMC9254511
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0102-6720&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0102-6720&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0102-6720&client=summon