Sucupira Eduardo, Matta Renato, Zuker Patrícia, Matta Jorge, Arbeláez Juan Pablo, Uebel Carlos O
Full member of SBCP, Santa Casa da Misericórdia Hospital of Rio de Janeiro, Rio de Janeiro, Brazil.
Plastic Surgery Resident, São Lucas Hospital of PUC-RS, Porto Alegre, Brazil.
Aesthetic Plast Surg. 2016 Oct;40(5):785-91. doi: 10.1007/s00266-016-0685-y. Epub 2016 Aug 5.
About one in ten patients experiences iatrogenic events, and more than half of these occur in the perioperative environment. The objective of this study was to develop a complete and functional checklist for aesthetic plastic surgery and test it in patients who would undergo elective plastic surgeries.
Patient data were collected from a general hospital and the particular clinic between October 2013 and October 2015, through history, physical examination, diagnosis, laboratory tests, pre-, during, and postoperatively, and complications. An expanded safety checklist was developed and optimized for aesthetic plastic surgery based on the model presented by the WHO in 2009 with reference to the information related to the prevention of more frequent complications in this specialty.
The tool was applied to 486 patients, of whom 430 (88 %) were women and 56 (12 %) were men. The most frequently performed procedure was liposuction with 30 % of cases, and the most widely used type of anesthesia (39 %) was local anesthesia + sedation. The greater adherence of professionals to the checklist was the group of residents (98 %). The observed complications were seromas (7 %), other complications unrelated to the wound (3 %), and hematoma (0.2 %) in only one patient who underwent facelift.
The use of the checklist in addition to allowing data collection and the identification of potential risks promoted favorable changes in the attitudes of some professionals and generated interest in patient safety and teamwork.
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约十分之一的患者会经历医源性事件，其中一半以上发生在围手术期。本研究的目的是制定一份完整且实用的美容整形手术检查表，并在将接受择期整形手术的患者中进行测试。
2013年10月至2015年10月期间，从一家综合医院和特定诊所收集患者数据，包括病史、体格检查、诊断、实验室检查、术前、术中和术后情况以及并发症。基于世界卫生组织2009年提出的模型，并参考该专业中预防更常见并发症的相关信息，为美容整形手术制定并优化了一份扩展安全检查表。
该工具应用于486例患者，其中430例（88%）为女性，56例（12%）为男性。最常进行的手术是吸脂术，占病例的30%，最常用的麻醉类型（39%）是局部麻醉+镇静。专业人员对检查表依从性更高的是住院医师组（98%）。观察到的并发症包括血清肿（7%）、其他与伤口无关的并发症（3%），以及仅1例接受面部提升手术的患者出现血肿（0.2%）。
检查表的使用除了允许收集数据和识别潜在风险外，还促进了一些专业人员态度的积极转变，并激发了对患者安全和团队合作的关注。
证据等级IV：本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
