Reconstructive surgery in the context of Covid-19: complications in the treatment of an inguinal complex wound

Introducao: No final de 2019, o mundo viu surgir uma nova sindrome respiratoria denominada Covid-19, causada por um novo tipo de coronavirus, o Sars-CoV-2 Classificada como uma pandemia, ela tem causado impactos de magnitude ainda imensuraveis Relato de caso: Homem de 57 anos desenvolveu ferida inguinal direita, apos exploracao cirurgica por infeccao de protese usada em bypass femoro-popliteo A equipe de cirurgia plastica optou pelo tratamento com desbridamento cirurgico, associado com terapia por pressao negativa para preparo do leito da ferida No pos-operatorio, apresentou sindrome respiratoria aguda grave e suspeita de Covid-19, com necessidade de intubacao e de cuidados intensivos Foi colhido amostra para RT-PCR do Sars-CoV-2 e associado ao tratamento as medicacoes cloroquina e azitromicina Apesar do tratamento intensivo, o paciente foi a obito O resultado do exame RT-PCR para o novo coronavirus foi positivo, sendo liberado dois dias apos a morte Discussao: A analise deste relato permite supor que o paciente provavelmente contraiu o novo coronavirus dentro do proprio hospital, pois o mesmo encontrava-se internado pelo periodo dos 35 dias anteriores a evolucao para insuficiencia respiratoria Esse fato, juntamente com sua evolucao desfavoravel, corrobora a orientacao de minimizar ao maximo as internacoes e os procedimentos cirurgicos a fim de promover maior seguranca ao paciente e a equipe de saude Conclusao: Pacientes internados estao susceptiveis a infeccao pelo novo coronavirus e podem configurar grupo de maior de risco, uma vez que muitos deles ja se encontram debilitados Introduction: At the end of 2019, the world saw the emergence of a new respiratory syndrome called Covid-19, caused by a new type of coronavirus, Sars-CoV-2 Classified as a pandemic, it has caused impacts of considerable magnitude Case Report: A 57-year-old man developed a right inguinal wound after surgical exploration for infection of a prosthesis used in a femur-popliteal bypass The Plastic Surgery team opted for treatment with surgical debridement associated with negative pressure therapy to prepare the wound bed In the postoperative period, he had severe acute respiratory syndrome and suspected Covid-19, requiring intubation and intensive care A sample for RT-PCR of Sars-CoV-2 was collected, and the medications chloroquine and azithromycin were associated with the treatment Despite intensive treatment, the patient died The result of the RT-PCR test for the new coronavirus was positive, being released two days after death Discussion: The analysis of this report allows us to suppose that the patient probably contracted the new coronavirus at the hospital, as he was hospitalized for 35 days before the evolution of respiratory failure This fact, together with its unfavorable evolution, corroborates the orientation of minimizing hospitalizations and surgical procedures as much as possible to promote more safety for the patient and the health team Conclusion: Inpatients are susceptible to infection with the new coronavirus and can set up a group at higher risk since many of them are already weakened