Proposal for a Protocol for Adaptation of the Oral Environment Prior to Major Surgery: A Series of Cases.

The intensive involvement of the dentistry team as a multidisciplinary strategy in the preoperative period showed an accelerated recovery of patients undergoing oncological surgery. Protocols were adopted that included oral preparation before surgery, which brought good results in the postoperative period for these patients. However, perioperative oral practices as a protective factor have not yet been well understood and need to be further studied. OBJECTIVE: to present a medical-surgical care protocol for patients, with adaptation of the oral environment prior to major orthopedic surgeries, specifically hip arthroplasty, in a university hospital. SAMPLE: 23 patients who underwent an outpatient consultation with the orthopedic surgeon and were referred to the hospital's dentistry service to adapt the oral environment prior to hip arthroplasty surgery. MATERIAL AND METHOD: Case series study in which the hospital records of 23 patients were evaluated to investigate the main postoperative complications found in a group where 100% of patients underwent previous mouth preparation. For this purpose, dental records were collected with patient data such as the patient's medical record number, odontogram and report on the execution of the dental procedures performed. Two years after the adoption of this system, the patients' medical records were coded and analyzed by a researcher who, using the hospital's computer system, verified the length of stay for each patient, the execution of the procedure in the surgical center and the main reports of complications in each patient. patient such as postoperative infection, pneumonia, admission to an intensive care unit as well as the hospital discharge report. RESULTS: We observed that 100% of patients who underwent previous mouth preparation, none contracted pneumonia; There were no reports of dental loss or trauma during intubation or throughout the hospitalization period; The average length of stay was 9 days; There was one admission to the intensive care unit with a history of sepsis, cardiac arrest and subsequent death; Among the most reported postoperative complications, in addition to pain, we found volunteers with infection at the surgical site and two volunteers with deep vein thrombosis; 15 volunteers were discharged from hospital.