Bacterial infection in burn wounds can jeopardize healing and can even lead to a patient’s death. Recently using a topical wound dressing with antimicrobial ability has been increasing. An ideal dressing for a burn wound is required to be antimicrobial, pain free and able to control the wound moisture to facilitate healing. In this research, a UV-radiation grafting method for depositing polyacrylamide (PAM) layer was used to improve the non-adherence properties of two commercially available silver based wound dressings. The dressing adherence, evaluated via an in vitro gelatine model, dramatically decreases after the deposition of PAM. This deposition did not negatively affect the antibacterial ability and cytotoxicity of the dressings. Furthermore, a poly(amidoamine) dendrimer based biocide was incorporated into PET dressings coated with poly(acrylic acid-co-acrylamide ) hydrogel. The resulting dressing was able to release a therapeutic dose of the antimicrobial agent in a sustained manner. / February 2016

Introdução: A infecção de sítio cirúrgico representa a terceira causa de infecção relacionada à assistência à saúde, que mais acomete pacientes na Europa e no Brasil. Considerando as altas hospitalares cada vez mais precoces e que grande parte das infecções do sítio cirúrgico se manifestará até o sétimo dia após a cirurgia, a vigilância pós-alta se faz extremamente necessária, uma vez que sua não realização pode levar a subnotificação, dificultando as ações de prevenção e controle. Existe carência, até o momento, de ferramentas que tenham sido validadas para a identificação de potenciais casos de ISC durante a vigilância pós-alta. Objetivo: Criar e validar um instrumento para a detecção pós-alta de potenciais casos de ISC. Método: Estudo psicométrico para a criação e validação de um instrumento, empregando-se as etapas de validação de conteúdo, critério e constructo. Resultado: O instrumento, após validação de conteúdo com juízes especialistas, apresentou coeficiente de validade de conteúdo total igual a 0,87. Para a validação de critério e constructo o instrumento proposto foi aplicado em uma amostra de 100 pacientes e comparado ao exame físico por profissional de saúde, observando-se coeficiente alfa de Cronbach igual a 0,87; Kappa de Cohen igual a 0,83; sensibilidade igual a 76,4%; especificidade de 100%; valores preditivo negativo de 92,5%, e preditivo positivo igual a 100%; precisão de 94%. Conclusão: O instrumento proposto foi validado e demonstrou ser uma ferramenta útil para detecção de possíveis casos de infecção de sítio cirúrgico na vigilância pós-alta. / Introduction: Surgical site infection (SSI) represents the third cause of healthcare-associated infections, which affects patients in Europe and Brazil. Considering hospital discharges that are becoming more precocious and that most SSI will manifest themselves up to the seventh postoperative day, postdischarge surveillance is extremely necessary, since its failure to perform can lead to underreporting, making it difficult to prevention and control actions. There is a lack, until now, of tools that have been validated for the identification of potential cases of SSI during postdischarge surveillance. Objective: To create and validate an instrument for the postdischarge surveillance of potential SSI cases. Method: a psychometric study for the creation and validation of an instrument, using content, criterion and construct validation. Result: The instrument, after validating content with expert judges, presented coefficient of total content validity equal to 0.87. For the validation of criterion and construct the instrument was applied in a sample of 100 patients. Comparing the instrument to the physical examination by the health professional, Cronbachs Alpha was equal to 0.87; Cohen\'s Kappa was equal to 0.83; sensitivity equal to 76.4%; specificity of 100%; negative predictive values of 92.5%, and, positive predictive equal to 100%. The accuracy of the instrument was 94%. Conclusion: The proposed instrument was validated and constitutes a useful tool to detect possible cases of Surgical Site Infection in postdischarge surveillance.

Introdução: As infecções do sítio cirúrgico (ISC) estão entre as principais complicações em pacientes submetidos ao transplante de fígado, com incidências que variam de 10,4% a 23,6%. Ademais, recente revisão da literatura aponta lacunas entre os fatores de risco para esta população específica. Objetivo: Analisar a incidência e os fatores de risco para o desenvolvimento de ISC entre pacientes adultos submetidos ao transplante de fígado. Método: Coorte histórica, realizada por meio de consulta a prontuários de pacientes adultos submetidos ao transplante de fígado entre os anos de 2009 e 2015, em um hospital filantrópico do interior do Estado de São Paulo. O projeto foi aprovado pelo Comitê de Ética em Pesquisa da Escola de Enfermagem da Universidade de São Paulo. Para análise dos dados utilizou-se medidas de tendência central e de variabilidade, os testes 2 de Pearson, teste exato de Fisher, Mann-Whitney e Wilcoxon-Mann-Whitney. Após análise bivariada, as variáveis foram incluídas em um modelo de regressão Classification and Regression Tree. Resultados: Foram investigados os prontuários de 156 pacientes submetidos ao transplante de fígado, dos quais 26,9% desenvolveram ISC. Verificou-se que elevado tempo cirúrgico (>487 minutos) associado a diferenças de índice de massa corporal entre doador e receptor (>1,3 kg/m2) aumentaram a chance de ISC em aproximadamente 5,5 vezes (OR 5,5; IC 95% 2,5-11,8); e glicemia capilar (>175 mg/dl) nas primeiras 96 horas de pós-operatório elevou a chance de ISC em aproximadamente três vezes (OR 2,97; IC 95% 1,43-6,17). Os principais micro-organismos isolados em sítios de coleta diretamente relacionados à ISC foram Staphylococcus sp., P. aeruginosa, Klebsiella sp., A. baumanii e C. albicans. Conclusão: Encontrou-se elevada incidência de ISC entre a população estudada. Os fatores de risco encontrados para esta categoria de pacientes diferem dos amplamente apontados pela literatura científica em outras categorias ou especialidades cirúrgicas. / Introduction: Surgical site infections (SSI) are one of the main liver transplantation complications with incidence varying between 10.4% to 23.6%. Recent literature review shows gaps between risk factors within this specific population. Objective: To analyze the incidence and the risk factors in the development of SSI among adults submitted to liver transplantation. Methods: Historical cohort done through records of adults submitted to liver transplant between 2009 and 2015 in a philanthropic hospital in the countryside of Sao Paulo state. The Research Ethics Committee of School of Nursing of University of Sao Paulo approved the project. Data was analyzed by central tendency and variability measures, Pearson X2-test, Fisher exact test, Mann Whitney test and Wilcoxon-Man Whitney test. After the bivariate analyzes, the variables were included in the Classification and Regression Tree model. Results: The records of 156 patients submitted to liver transplant were investigated, of which 26.9% developed SSI. Prolonged operative time (>487 minutes) associated with Body Mass Index differences between donator/receptor (>1.3kg/m2) increased the chance of SSI in approximately 5.5 times (OR 5,5; CI 95% 2,5 - 11,8); and in the first 96 postoperative hours capillary glycemia (>175 mg/dl) increased the chance of SSI in approximately three times (OR 2.97; CI 95% 1.43 6.17). The main microorganisms isolated in collection sites related to SSI were Staphylococcus sp., P. aeruginosa, Klebsiella sp., A. baumanii and C. albicans. Conclusion: There is high incidence of SSI among the studied population and the identified risk factors for this patients category are highly diverse from the ones indicated by scientific literature in other categories or surgical specialties.

Trata-se de uma revisão integrativa da literatura com objetivo de identificar e analisar as evidências oriundas de estudos primários que abordaram a relação entre a transfusão sanguínea e a ocorrência da infecção de sítio cirúrgico, em pacientes adultos submetidos à cirurgia eletiva. A busca foi realizada em abril de 2012 nas bases de dados PUBMED/ MEDLINE, CINAHL, LILACS e Biblioteca Cochrane e utilizou-se o limite dos estudos indexados nos últimos 10 anos. Para a busca nas bases de dados eletrônicas foram utilizadas combinações entre os descritores controlados transfusão sanguínea, transfusão de componentes sanguíneos, cirurgia eletiva e infecção de ferida cirúrgica e os não-controlados infusão sanguínea, procedimento cirúrgico eletivo, cirurgia de não urgência e infecção de sítio cirúrgico, as quais resultaram na identificação de 2195 referências, dentre essas, 2112 foram excluídas devido a ausência em relação ao tema a partir da leitura de título e resumo. Assim, 73 estudos mostraram-se elegíveis e foram lidos na íntegra, dentre os quais, 50 estudos não foram selecionados e cita-se como motivo de exclusão para cinco estudos, que não analisavam a relação da infecção de sítio cirúrgico e a transfusão sanguínea, dois estudos incluíam indivíduos com idade inferior a 18 anos, 33 estudos consideravam cirurgias de urgência e emergência, quatro estudos transfundiam plasma e plaquetas e seis estudos não referenciavam infecção de sítio cirúrgico. Dentre os 33 estudos selecionados, 16 constavam de estudos repetidos e 17 estudos primários foram selecionados e incluídos na amostra, pois atenderam aos critérios de seleção da revisão. Para extração dos dados foi utilizado um instrumento validado. A análise dos dados foi descritiva e apresentada em duas categorias temáticas: pacientes que recebiam transfusão sanguínea e apresentavam a infecção de sítio cirúrgico como desfecho infeccioso; e pacientes com infecção de sítio cirúrgico, para os quais a transfusão sanguínea foi verificada como um fator de risco independente. As variáveis clínicas e cirúrgicas relacionadas com maior frequência e significância nos estudos foram: níveis de hemoglobina, perda sanguínea intra-operatória, quantidade de sangue transfundido, tempo de operação, escore do ASA, classificação da cirurgia e uso de antibiótico profilático. E a maior ocorrência de infecção de sítio cirúrgico foi verificada em mulheres, de maior idade e índice de massa corporal para obesidade. Um aspecto positivo a ser ressaltado é que a definição da infecção de sítio cirúrgico utilizada nos estudos primários incluído foi a mesma. No entanto, há necessidade de consenso para os níveis de hemoglobina indicativos de transfusão sanguínea e a implementação de assistência de enfermagem direcionada ao atendimento das reais necessidades deste paciente, minimizando os riscos e complicações inerentes ao procedimento anestésico-cirúrgico, educação para e vigilância pós-alta hospitalar para identificação precoce de infecção de sítio cirúrgico em pacientes submetidos à Obrigada pela força, cumplicidade e convivência. transfusão sanguínea. / The aim of this integrative literature review was to identify and analyze evidence from primary studies on the relation between blood transfusion and the occurrence of surgical site infection in adult patients submitted to elective surgery. The search was accomplished in April 2012 in the databases PUBMED/ MEDLINE, CINAHL, LILACS and the Cochrane Library and was limited to studies indexed in the last 10 years. For the electronic database search, combinations were used among the controlled descriptors blood transfusion, blood component transfusion, elective surgery and surgical site infection and the non-controlled descriptors blood infusion, elective surgical procedure, non-urgent surgery and surgical site infection, which resulted in the identification of 2195 references. Of these, 2112 were excluded due to the lack of relation with the theme, based on the reading of the title and abstract. Thus, 73 studies were eligible and were fully read, 50 of which were not selected. For five studies, the reason for exclusion was that they did not analyze the relation between the surgical site infection and the blood transfusion, two studies included individuals younger than 18 years of age, 33 studies considered urgency and emergency surgeries, four studies transfused plasma and platelets and six studies did not refer to surgical site infection. Among the 33 selected studies, 16 were repeated, so that 17 primary studies were selected and included in the sample, as they complied with the selection criteria for the review. To extract the data, a validated instrument was used. Data analysis was descriptive and presented in two thematic categories: patients who received a blood transfusion and presented surgical site infection as an infectious outcome; and patients with surgical site infection, for whom the blood transfusion was verified as an independent risk factor. The most frequently and significantly related clinical and surgical variables in the studies were: hemoglobin levels, intraoperative blood loss, amount of blood transfused, duration of surgery, ASA score, surgery classification and use of prophylactic antibiotics. And the highest incidence levels of surgical site infection were found in older women whose body mass index indicated obesity. One positive aspect to be highlighted is that the definition of surgical site infection used in the included primary studies was the same. A consensus is needed on what hemoglobin levels indicate blood transfusion and the implementation of nursing care in response to these patients\' actual needs, minimizing the risks and complications inherent in the anesthetic- surgical procedure, education for and surveillance after hospital discharge with a view to the early identification of surgical site infection in patients submitted to blood transfusion.

A crescente preocupação sobre as infecções relacionadas à assistência à saúde levou a Organização Mundial da Saúde a promover a criação da Aliança Mundial para a Segurança do Paciente, enfatizando ações básicas de controle de infecções. A redução de sua incidência implica em proteção para o paciente, profissionais e instituições, favorecendo a prestação da assistência livre de riscos. Dentre as mais frequentes, a infecção do sítio cirúrgico deve ser compreendida como elemento qualificador do cuidado e, os dados relacionados, o ponto de partida para as ações preventivas e de controle. Os hospitais têm dificuldades para realizar a vigilância epidemiológica pós-alta, tarefa complexa haja vista a tendência de redução do tempo de internação. Conhecer dados sobre a readmissão contribui para melhorar os dados de vigilância pós-alta. Foi realizado um estudo exploratório com o objetivo de descrever a epidemiologia das readmissões por infecções de sítio cirúrgico em pacientes em um hospital público de Belo Horizonte (MG). Foram avaliados 98 registros médicos e da Comissão de Controle de Infecção Hospitalar referentes aos indivíduos readmitidos por este motivo entre janeiro/2008 e dezembro/2009. Os resultados demonstraram que um quarto dos pacientes que desenvolveu infecção do sítio cirúrgico na instituição necessitou de nova internação. A idade média dos indivíduos foi de 57,2 anos; mais da metade apresentava diabetes mellitus, e um terço, hipertensão arterial sistêmica; no entanto, o risco anestésico para a maioria foi classificado como baixo. As infecções ocorreram com maior frequência em cirurgias limpas e potencialmente contaminadas, e as especialidades com maior número de pacientes readmitidos foram ortopedia, com mais da metade dos procedimentos relacionados à correção de fraturas, e cirurgia geral, na qual as hernioplastias/rafias e colecistectomias predominaram. Metade dos indivíduos recebeu biomaterial em suas intervenções. Os tempos cirúrgicos e de internação não diferiram dos estudos encontrados na literatura. Praticamente todos os pacientes utilizaram antibioticoprofilaxia, segundo protocolo da instituição. Os primeiros sinais e sintomas surgiram, em média, após 33,2 dias, e metade dos infectados teve o diagnóstico nos primeiros 30 dias de pós-operatório. A classificação das infecções mostrou que metade dos pacientes apresentou infecção de órgãos e cavidades e, para 60% deles, foram necessárias novas intervenções cirúrgicas, além do tratamento antimicrobiano. O micro-organismo predominante nas infecções ortopédicas foi Staphylococcus aureus e nas infecções da cirurgia geral Escherichia coli, ambos com perfil de resistência abaixo daqueles encontrados na literatura. O estudo permite concluir que a vigilância pós-alta e o monitoramento das taxas de readmissão contribuem para o redimensionamento do problema e definição de ações pontuais para seu controle. / The growing concern about infections related to health care led the World Health Organization to promote the creation of the World Alliance for Patient Safety, emphasizing basic actions to infection control. The reduction in the incidence of surgical site infection implies protection for patients, professionals and institutions favoring the assistance free of risks. Among the most frequent, surgical site infection should be understood as a qualifying element of care, and related data, the starting point for preventive and control measures. Hospitals have difficulties in achieving post-discharge surveillance, complex task given the trend of reduced hospital stay. Knowledge of the of readmission rates helps to improve reporting of post-discharge surveillance. An exploratory and descriptive study was conducted in order to describe the epidemiology of readmissions for surgical site infections in patients in a governmental hospital in Belo Horizonte (MG). We evaluated 98 medical records and the reports of the Hospital Infection Control Committee related to readmitted patients for this reason among january/2008 and december/2009. The results showed that one quarter of patients who developed surgical site infection in the hospital needed a new hospitalization. The mean age of subjects was 57.2 years; more than a half had diabetes mellitus, and a third, hypertension, however, the anesthetic risk for the majority was classified as low. The infections occurred more frequently in clean and potentially contaminated surgeries and the medical specialties with higher number of patients readmitted was orthopedic, with more than half of surgeries related to the correction of fractures, and general surgery, where the hernia and gallbladder surgery predominated. Half of the subjects received biomaterial in its proceedings. The surgical and hospitalization times did not differ from others studies in the literature. Virtually all patients received antibiotic prophylaxis for indications mentioned in the protocol. Early signs and symptoms appeared after an average of 33.2 days, and half of the patients were diagnosed within the first 30 days postoperatively. The classification of infections showed that half of the patients had infection of organs and cavities and 60% were required surgical interventions, in addition to antimicrobial treatment. Staphylococcus aureus predominated in orthopedic procedures and Escherichia coli in general surgery, both with multi-resistance profile below the results presented in other studies. The study concludes that the post-discharge surveillance and monitoring of readmission rates contribute to the scaling of the problem and define specific actions for its control.

Nationella riktlinjer finns dokumenterade i en handbok utgiven av Sveriges kommuner och landsting. I denna handbok finns de hygienregler beskrivna som ska gälla på våra operationsavdelningar. Syftet med studien är att kartlägga vilka hygienregler som gäller inom region Skånes nio opererande sjukhus och om det finns någon vetenskaplig evidens bakom dessa regler. Metoden som har använts är en empirisk intervju med kvantitativ inriktning utifrån 17 halvstrukturerade frågor. Respondenterna var elva avdelningschefer/hygienansvarig på operationsavdelningar i region Skåne. Intervjuerna genomfördes via telefon.Resultatet visar att alla operationsavdelningar har egna styrande dokument/PM angående hygienregler. Gemensamt för alla avdelningar är att de har lika kläder, använder mössor, har regler för att vit knäppt rock används vid ärende utanför operationsavdelning samt att hygiensköterskan har en rådgivande funktion på alla sjukhus. Det som skiljer sig markant mellan avdelningarna är reglerna för smycken, munskydd, klädförvaring och postoperativ infektionsregistrering. Då det inte finns några tydliga nationell/regionala hygienregler eller någon vetenskaplig evidens som styrker dessa, blir slutsatsen därför, att varje operationsavdelning tolkar hygienreglerna godtyckligt. Detta visar sig tydligt i de stora variationerna på svaren från intervjuerna. Postoperativ infektionsregistrering och gemensamma hygienregler för hela region Skånes/Sveriges operationsavdelningar bör vara en självklarhet inom svensk sjukvård. / National hygiene guidelines are documented in a handbook written by Swedens municipality and country council. In this handbook there are special hygiene rules for the operating theatre. The aim of this study was to map out the hygiene rules in operating theatre at nine hospitals in Skåne, and to find out if the rules are based on evidence. The method used was an empiric quantitative interview with seventeen semistructed questions. The respondents were eleven head nurses/hygiene responsible at the operating theatre at nine hospitals in Skåne. The interviews were accomplished by the telephone. The result shows that all operating theatres have different version with regulations of hygiene rules. In common for all were that personnel were wearing the same type of green clothes, all personal use head cover, and when they have to leave the operating theatre in some errand they wear a white-buttoned coat over the green clothes. The rules for jewellers, facemask, clothes keeping and the registration of postoperative infections differ between the hospitals. As long as there is no evident national hygiene regulation with scientific evidence that proves the outcome, it seems to be free rendering. Registration of postoperative infection and common evident hygiene rules should be self-evident in all Skånes/Swedens operating theatre in the future.

INTRODUCTION: For persons with diabetes, surgery is fraught with complications; of primary concern is postoperative infection. A postoperative infection rate of up to 13% has been noted in patients with diabetes undergoing elective surgical procedures compared with less than 3% in nondiabetic populations. OBJECTIVE: The objective of this study was to provide preliminary evaluation of the efficacy of a novel bioresorbable microfilm matrix (20 µm thick) containing very low amounts of silver (0.16 mg/in²) in preventing surgical site infections when placed at the level of subcutaneous tissue and dermis prior to primary closure in the patient with diabetes undergoing elective surgery. MATERIALS AND METHODS: Twenty-two patients with diabetes undergoing nonemergent or elective foot or ankle surgery and who met at least 1 of the following 6 criteria were included in the study: neuropathy, infection, open wound, history of recurrent infection, nonhealing wound, or peripheral vascular disease. Patients underwent amputation, removal of exostosis, midfoot bone removal, Achilles tendon repair, bunionectomy, or an elevating osteotomy with primary closure of the wound. After hemostasis was obtained and subcutaneous closure achieved, if applicable, the bioresorbable microfilm matrix was applied just deep to the incision at the level of subcutaneous tissue and dermis, and the incision primarily closed. A nonadherent cover dressing was applied over the suture line, and routine follow-up was scheduled for 3 to 5 days later. RESULTS: No patient exhibited signs of infection at initial follow-up, and all adherent patients achieved complete healing during the 3-month follow-up period. Eighteen patients healed at a rate typical for the respective procedure. In 2 patients, time to healing was delayed secondary to weight-bearing dehiscence. Two patients were not included in the results secondary to multiple infractions of nonadherence with the postoperative protocol. CONCLUSIONS: The application of microfilm matrix in surgical incisions at the level of subcutaneous tissue and dermis prior to primary closure is safe for and has the potential to prevent postoperative surgical site infections in at-risk patients with diabetes..

Background: Pyoderma gangrenosum after cardiac surgery is a rare, noninfectious ulcerating skin disease mimicking sternal wound infection. Methods: A systematic search of literature for pyoderma gangrenosum complicating cases of cardiac surgerywas conducted between September 1985 and September 2020 on PubMed and Cochrane databases. A systematic review and detailed overview of clinical presentation, diagnostic, treatment, and outcome is provided. Results: A total of 15 studies enclosing 15 patients suffering from pyoderma gangrenosum following cardiac surgery were identified. Onset of symptoms was observed after a median of 5 days. Patients were predominantly male (81.3%) with a median age of 64 years. Typical clinical presentation mimicked sternal site infection, mainly by means of mediastinitis. Specific signs were rapid progression, erythematous to violaceous color of the wound border, accompanied by unspecific symptoms including fever, malaise, and severe pain. Additionally, pathergy (development of ulcers at the sites of minor cutaneous trauma) was reported frequently. Biopsy is mandatory with a cutaneous neutrophilic inflammation confirming the diagnosis. Initial treatment mostly (75.0% of reported cases) was misled, addressing suspicion of surgical site infection. After correct diagnosis, the treatment was switched to an immunosuppressive therapy. Full sternal wound closure took between 5 weeks and 5 months. Reported case mortality was 12.5% in actually low-risk surgeries. Conclusion: Despite pyoderma gangrenosum has typical signs, it remains an exclusion diagnosis. The treatment is completely opposite to the main differential diagnosis —the typical surgical site infection. Knowledge about diagnosis and treatment is essential in the context of avoiding fatal mistreatment.

Orientador: Adriana Polachini do Valle / Resumo: A infecção de sítio cirúrgico é uma das complicações mais importantes e frequentes no cuidado do paciente, gerando grande ônus ao mesmo e à instituição. A profilaxia antimicrobiana é uma das principais ferramentas no combate à essas infecções, contudo, estudos apontam elevadas taxas de erros em seus processos, aumentando o risco de infecção de sítio cirúrgico e o prolongamento da internação e gastos hospitalares. Este estudo objetivou desenvolver e validar um aplicativo para auditoria e controle da profilaxia antimicrobiana em sítio cirúrgico para dispositivos móveis, baseando-se no protocolo adotado pela Comissão de Controle de Infecção Relacionada à Assistência à Saúde (CCIRAS) do Hospital das Clínicas de Botucatu e pesquisas recentes da instituição. O desenvolvimento do aplicativo foi realizado utilizando a ferramenta Xamarin, que permite o desenvolvimento de aplicativos de maneira multiplataforma. A validação foi realizada por meio de entrevistas com 10 especialistas de áreas que trabalham diretamente com profilaxia antimicrobiana, onde foram avaliados a usabilidade, apresentação e informações do modelo proposto. Nestas entrevistas, utilizou-se do Índice de Validação de Conteúdo (IVC) e Coeficiente de Kappa para avaliação da concordância entre os juízes, sendo definido como valores mínimos ideais de 0.75 e 0.61, respectivamente. A validação do sistema demonstrou excelentes resultados, onde os itens avaliados apresentaram uma boa classificação, com IVC igual ou superior a ... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Surgical site infection is one of the most important and frequent complications in patient care, generating a great burden on the patient and the institution. Antimicrobial prophylaxis is one of the main tools for the prevention of these infections; however, studies indicates that there are high error rates in this process, which can increase the risk of surgical site infection, prolong hospitalization time and increases hospital expenses. This study aimed to develop and validate a mobile application to audit and control antimicrobial prophylaxis in surgical site process, based on the protocol adopted by the Infection Control Committee related to Health Care (ICCHC) of the Hospital das Clínicas de Botucatu, and recent researches at the institution. The development of the system was carried out using the Xamarin development platform, which allow the development of multiplatform applications. The validation process was conducted with interviews from 10 experts that works directly in areas related to antimicrobial prophylaxis, evaluating the usability, presentation and information of the proposed model. In those interviews, the Content Validity Index (CVI) and Kappa Coefficient were used to evaluate the concordance between the judges, having defined as ideal minimum values of 0.75 and 0.61, respectively. The system’s validation showed excellent results, where all the evaluated items received a good classification, with a CVI equal to or higher than 0.90 and Kappa Coefficient equ... (Complete abstract click electronic access below) / Mestre

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