Ninfoplastia: Uma Análise Completa das Técnicas Cirúrgicas e seus Desdobramentos Emocionais

Introduction: Nymphoplasty, also known as labiaplasty, is a surgical procedure that has gained increasing prominence in the area of ​​female genital plastic surgery. In this context, a complete analysis of the surgical techniques involved in nymphoplasty and their emotional impacts is essential, in order to better understand the benefits and potential psychological repercussions of this surgical intervention. Objective: Explore and understand the surgical techniques involved in nymphoplasty, analyzing the pre- and post-operative emotional impacts on patients. Methodology: The Google Scholar, Scielo and Medline databases were used, searching for articles published between 2015 and 2023, in Portuguese or English. Final Considerations: Based on the analysis of the surgical techniques involved in nymphoplasty and its emotional consequences, it is possible to conclude that this surgery represents an effective option for women seeking to improve their genital self-image and reduce symptoms of discomfort or dissatisfaction. Therefore, a holistic approach, which takes into account not only the technical aspects of the surgery, but also the psychological well-being of patients, is crucial to guarantee satisfactory and lasting results.Introdução: A ninfoplastia, também conhecida como labioplastia, é um procedimento cirúrgico que tem ganhado cada vez mais destaque na área da cirurgia plástica genital feminina. Neste contexto, é fundamental uma análise completa das técnicas cirúrgicas envolvidas na ninfoplastia e de seus impactos emocionais, a fim de compreender melhor os benefícios e as potenciais repercussões psicológicas dessa intervenção cirúrgica. Objetivo: Explorar e compreender as técnicas cirúrgicas envolvidas na ninfoplastia, analisando os impactos emocionais pré e pós-operatórios nas pacientes. Metodologia:  Foram utilizadas as bases de dados Google Scholar, Scielo e Medline, buscando artigos publicados entre os anos de 2015 e 2023, nos idiomas Português ou Inglês. Considerações Finais: Com base na análise das técnicas cirúrgicas envolvidas na ninfoplastia e em seus desdobramentos emocionais, é possível concluir que essa cirurgia representa uma opção eficaz para mulheres que buscam melhorar sua autoimagem genital e reduzir sintomas de desconforto ou insatisfação. Portanto, uma abordagem holística, que leve em consideração não apenas os aspectos técnicos da cirurgia, mas também o bem-estar psicológico das pacientes, é crucial para garantir resultados satisfatórios e duradouros

Critical care admission following elective surgery was not associated with survival benefit:prospective analysis of data from 27 countries

Purpose: As global initiatives increase patient access to surgical treatments, there is a need to define optimal levels of perioperative care. Our aim was to describe the relationship between the provision and use of critical care resources and postoperative mortality. Methods: Planned analysis of data collected during an international 7-day cohort study of adults undergoing elective in-patient surgery. We used risk-adjusted mixed-effects logistic regression models to evaluate the association between admission to critical care immediately after surgery and in-hospital mortality. We evaluated hospital-level associations between mortality and critical care admission immediately after surgery, critical care admission to treat life-threatening complications, and hospital provision of critical care beds. We evaluated the effect of national income using interaction tests. Results: 44,814 patients from 474 hospitals in 27 countries were available for analysis. Death was more frequent amongst patients admitted directly to critical care after surgery (critical care: 103/4317 patients [2%], standard ward: 99/39,566 patients [0.3%]; adjusted OR 3.01 [2.10–5.21]; p < 0.001). This association may differ with national income (high income countries OR 2.50 vs. low and middle income countries OR 4.68; p = 0.07). At hospital level, there was no association between mortality and critical care admission directly after surgery (p = 0.26), critical care admission to treat complications (p = 0.33), or provision of critical care beds (p = 0.70). Findings of the hospital-level analyses were not affected by national income status. A sensitivity analysis including only high-risk patients yielded similar findings. Conclusions: We did not identify any survival benefit from critical care admission following surgery

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine