Sunday, December 17

What Are The Risks Involved in Surgery?

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According to World Health Organization (WHO), between 3% and 16% of high complexity surgeries performed in developed countries recorded major complications. In general, people are aware that a problem may occur when someone close or themselves undergo a major surgery or more complex. However, most believe that nothing can go wrong with more simple procedures, sometimes conducted in offices or clinics, where, or have resources to deal with a cardiopulmonary emergency, for example. There is indeed a relationship between risk and complexity of the surgery. But all surgical procedures, however simple they may be, may have problems. However, there are many ways to prevent them or minimize them. 

An action that has helped to reduce the occurrence of problems is the request by the doctor, a preliminary evaluation of surgical and anesthetic risk. Even for less complex procedures, it is common practice to assess cardiac and respiratory and conducting some additional tests that can detect changes, especially heart, which do not manifest symptoms. In recent years, guidelines were established in Brazil, North America and Europe, with criteria that relate the type of surgery to the risk profile of each patient and determine which tests should be performed. The clinical interview with the patient is essential and should be the first assessment to be made. Allergies, previous surgeries and other health problems should also be taken into account. 

All surgical procedures, however simple they may be, may have problems. However, there are many ways to prevent them or minimize them.

One possible complication is infection of the surgical site. Despite advances in prevention, contamination by bacteria and other microorganisms is a real possibility. Part of this risk is related to the surgery itself, but the contamination may derive from other sources, such as improper practices during the procedure and failures in the processing of materials and tools used. These can be prevented with proper sterilization, strict procedures and trained personnel. 

Human errors are also the source of undesirable events. Most of them however can be avoided with a simple and powerful tool, the checklist, a practice encouraged by the WHO. This is a list of items that must be checked by nursing staff, anesthesia and surgery immediately before surgery. The list includes several elements, some seemingly obvious, such as patient identification and marking of the site to be operated. Demanding a few minutes to run, the checklist has been important to reduce risks in surgery at the institutions that is adopted. 

Surgery without risks is a myth, but there are many possibilities for prevention and minimization. It is for professionals and institutions to incorporate the best features and security practices and to inform patients with clear and honest about risks, alternatives and benefits associated with the procedure prior to signing the consent forms of surgery and anesthesia. The patient has the right to know them to make their own choices.


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