cirurgias seguras

1. 482 Rev. Ciênc. Méd. Biol., Salvador, v.12, especial, p.482-485, dez.2013
&uD}v]}>]vZ}]P^]o
^Zlo]_>]s].}^Pv]•P]W
o]}]vv}
Zlo]^P]o^(˙Wuvv]vv}v
&uD}v]}U>]vZ}]P^]oł
v(u]XDv}W}PuWrP}W}}/v}}MP}^]uU/^th&V
łW}(}d]oXuv}W]]U&Dth&XW}PuWr’}
W}}/v}}MP}^]uU/^th&X
Zu}
/v}}W KPv]}Dv]o^•ov}uo]vDv]o^Pv}W]v}u}}i}
]}}}u}uuv}v}}.]}v]•(]}Pv]!v]}]v
v}u]v]•P]}X Ki}W }Zlo]}>]s].}^Pv]•P]X D}}o}P]W P}]}
o
}}}}vo]}}Zlo]o]}vv}}u
}}}.]}v]X&}uo]
o]
KPv]}Dv]o^•}]P]^P^ous]U}v(}u]vo_}P}o]}v}v}
ııU}uvo]}}v•}v}v(}u]X Zo}W K]}}}.]}v]v}o]}!u
o(vuvov}]vo}}Zlo]U}}}u_o](}u}v
.]vX }vo}W KZlo]to]].}]P]t}o]}}u}(v]o}Pv]}U
}(v]}v]}}P]}]}}u}]vXK]}!uo(vuvov}˘
U.u(}} P]v}.}Pv}]v]•P]}Xv]}U}v}U}
o}˘]!v]iu]oP}]]]uouv}X
WorZW ]P]Vv(uPuV^PvX
Abstract
Background: dZt}o,oZKPv]}vovZ]vZt}ooo]v(}Wv^(˙]v}}}]]}vv
}uu]uvu}vPZoZ}(]}voU]v]`}]u}Z(˙}(v]vZP]ov]}vuvX KiW
d}]ZZlo]}^P]o^(˙Zlo]X Methodology: Z]`oZZ]PZo]PZ}(Z}]vo˙]vP
ZZlo]ovP}Z`}l}(}(]}voXWo]}v}(Zt}o,oZKPv]}v}v^(^P˙^>]`Z
oo]Z`vZ˙ıır`]voU`]Zvo˙]}(Z}vv`v]vZ](}u
`X Results: ^]v}(]}vo]v}oZ(vuvo}o]vZZlo]}vv]voo}vU}]vP
}ZZ]}(Z]}v]v}v]vv8]vuvvX Conclusion: dZZlo]r^P˙Zlo]rv
(v(}Z}Pv]}v}(Zuo}˙Uv(}Z}}(vX^]o˙l˙}o]vZ}v
}(}uZ]U]v}}}u}Z]v}ZP]]vZ]˙ZoovP}(ZP]ovXdZ(}Z
]vZ}}(˘]uv}U}}Z]uouv}v}(Z]X
Keywords: ^P˙VE]vPV^(˙X
Zd/’K Z s/^K
/^^Eræı
⁄ Z]]!v]D ]]}oP]
}}v!v]l}}vvW &uD}v]}UZD}vvZ}
’^}lUv£U}XU}oU^o}rZ]r]oUWW
rXru]oWu}v]}(uZ}u]oX}u
/EdZKhK
E}•ou}v}Uur}}uuv r
} P]}o}u]u}}]}v r
Pv}]vu}}]uv}]•P] r
}X
}}}u Pv}]v] r
•P]}u]}vU]}o(!v]
}v}}Uvu]}]}}U
}]u]}v]}XtZ}&~ı}v r
]uæ9}}!v]]u]]X
Wo]}]u}v]
v}u} Pvv}u]v]•P]}U r
u]r v} ]oU u U (}u o]}
XæXæ}]uv}]•P]}Uvv}u
o}}oZ¤XıXıııXæıUXE}v}P]vU}
iUuU(}uXXı}]uv}U}o] r
v}Z¤æXæXXU~d^h^UX
Pv }v]u]v]} r
o]]!v]u}}v}o]}u} r
}]}v}}o]}
u]}v]]uoU}u}ZPu
u]]U]uv}U]v.}]v(}u}
}}]vX
^Pv}KPv]}Dv]o^•U r
Pv}]v}ov !
}uouvW] }}!v] v}
}V(]o]]o]}Vu]v]u]}(] r
} u].~KD^UX
}v]v}rv}U}Z}] r
o}].vo]]}•}u
Pv}o} v]uv r
}u]]o]}Xv}]} r
}Z}v}]•P]}]

2. 483
Rev. Ciênc. Méd. Biol., Salvador, v.12, especial, p.482-485, dez.2013
^Zlo]_>]s].}^Pv]•P]Wo]}]vv}
]vuv}ov}o}P]U!uv}PP r
}}o}vP}}v}U}u}}i} u
]!v] PU ]v]]o] o]U }
]vX
s]}}}v}u}uPv
vuvvPv }o_ •
v]}vo]vv]}voXu}]uv}u}o_ r
}(}uvv]vP}Pv r
}]vU}v}o]uv}o]}}]u r
}u]}uPPvZ}o_v]}U
}]]}vu]}~^Kh^UX
u}}UKPv]}Dv]o
^•ov}(}uouvo]vDv]o^ r
Pv } W]vU }u } }i}
}v]!v]}}u}uuv}}o_}U.uu r
oZ}Pvv]!v]X]v]}U}_
!uov}u]]v r
o]v~Z^/>UX
KPv]
}Dv]o^•hv]
]
,
]uUu
U}}Pu^]P]^P r
^ous]
_U}v]
v}
!
ouv}
]v]]W
]oP}}}viv}]v
uv}v}ou
u
o]}v}}u]vUu
]]
]uv r
}V}
v}o]uv}}
}.]}v]
(}u]v]] r
ou]V
uo
o]
}
uvZu
u]vo}ov]}vo}
}uU}v]
v}
}
}uu}
KPv]
}Dv]o
^• r
iu}u}u
}u]uouvu]
o r
v
P
v
]•P]
~>>K
oXU
X
E}]oU}D]v]]}^•u]}u
KPv]
} Wvru]v ^• KPv]
}
Dv]o^•~KW^lKD^(}u}}v]o
v}}i}]}v]]v
v
]}(}
o]
]!v]
}
]vX
v}
} v]}]}v]]o]}o}
}oP!v]E]}vo^•~Es/^U}uvo
^]P]^P^ous]_vu^Z r
lo]_t>]
s].
}^Pv]•P]~&]P
U
v}o]}}
]o]
X
}u}}}
! r
U
]
}u}W/v.
}~v
]v
}v r
]
U}v.u
}~v
]v]}]•P]
}ZP] r
}~v}]v]o}
~WE/Z/
oXU
X
^Pv} } uvo ]P] P
KD^ ~ ıU } }i ]} v o } }P u ^] r
P] ^P ^o us] _ (]v] u }viv}
_ ] u}P (] ] P] ]v r
} } u ] } o }U ]
}(}}}}}U]}u}}}uo]
](] } P v ]uouv }
}}}o} }v] } ] !v] ~&ZZ U
ıX
o] } u ] }v] ]uo
}u} Z Pu u ]]U ] uv}U] v] r
(] } ]v(}u } } } ]v } u }
o]u] v }( } } } } } ]uv}X
]uov } }^Z lo] _ }v] u ] r
] ( ]oU v} u] v ]u } ] ] r
] } ]v uv} v } }(] ]}v]
u u v} ]•P]}X v v}U o] r
]o] (] } u •v] } r
vZ ]} ] uv ]v ]] } } r
]uv} ]•P]}X KPv] } Dv]o ^•
&]PX Zlo]]P]P}}}oKPv]}Dv]o^•X_o]U&UX

3. 484 Rev. Ciênc. Méd. Biol., Salvador, v.12, especial, p.482-485, dez.2013
&uD}v]}>]vZ}]P^]o
P i } v( u]}U u} o } r
(] ]}vo ]v ]} ]v } v} } ]uv} ]• r
P]} } ] } }} v } ]]
~WE/Z/ oXU X
K ^Z lo] _ } ]o] } v} ] }
]} ] P]U o] uv } } r
]} ] v v v} ]v uv} ( v]o
o }Pv] } (v]}v ]}U ]} } P] }
] } }u} ]v ~: ,KU XK ] v
v v } uv} } }v] } }u}
]v] } o] ] !v]U v} u
} }v} o] } u } } ] }X
DdZ//^DdKK^
KvP}]}r} r
}Pv}]vu}} r
]uv}]•P]}v}^Zlo]_>]s r
].} ]P] ^P } !
W/v.}~v]v}v ]V}v r
.u}~v]v]}]•P]V}ZP]}~v
} ]v ] o }X Zour
}v}uu}uv}}}}o]}}
^Zlo]_ u u}o]}v}u }}
}.]}v]Xd}u}r}u}o]KP r
v]}Dv]o ^•}]P]^P^o r
us]U}v(}u]vo_}P}o]}v r
}v}ııU}]Uvo]}
}v•}v}v}U}v}v(}u r
]X
]u(uPuvo]
}}^Z -
lo]_
]
P]
P
]
uvZv}v
}]•P]}
!u}u}
_
}
oZ}}o
}U
v
}
}]
P]
Uv
]
Uv(
u]}Uv]}
v( r
uPuU˘]o]
v(
uPuUv]}
o}
]}U
]v
uv
}]•P]}v]}
]}o}P]Uv
} r
}
}.]}v]X
}
]
v(
uPuv}
v
}]• r
P]}(vuv
oUv}
˘
u]u}
v]U}]}
}.]}v]
u]
}
_.}U(}u]v]] r
o]
uoPv
}
o
}uo˘]
U} r
]v
}u]v]
}
}
]uv}v]}r]•P]}
~ZKZ/’h^UııX
]
v(
uPu
}v
o
o}
]
}
]}
]}]v}}o]vv}U
}v}
_}}r}
]}
}
v
] r
v}
r}
]}~
>>’ZK
oXU
X
E}(}
}}}]}vuoZ}]
!v]U
}u
v
P
v
}
]v
]
]•P] r
U
]}r
}^Z
lo]_to]
].
}
]
P] r
P
}u}}i
}
]
v}
}
]v
X
}^Zlo]_
]}}v
_}}u
u
]!v]
]v.
U
(vuv
o]u}
v]
}]v
uv}i
}o]}Pv]
}
}v ]uov
} ~’Z/’K>dKV ’/DE^Vs>ZU
X
v(uPu}u}}vooo]}
}^Zlo]_tu}i}_o}}}. r
]}vouot}(}u}}v}(]o] r
} }v]} v]u} v}
]}}]vv}]}]} ] r
v]o]}}Pv]}X
]}U v]} }.]}vovZ
}vZ]uv}i]v}o]}o]X
}]v}uoU}
ioPv]}U}}P]uv} ˘] r
u(XE}}}}o}]}o}v
ZPuU}}}]}v}o]X
}}}oZ ˘u]u}v]X
]uU } }.]}v] v}o]} v} }}
u }vZ]uv}} (uvU}u r
v]u}v]]v}}rov] r
]X
}.]}vo Z }}U
}v]v}}}}}v]oPv
}]vX
K^Zlo]_]P]Ptv]v -
}v]
E]u]}u}uv}U]}v} r
]vv}v}]•P]}Uu
v}v( r
u]}}v]Xv}]P]}v} r
v]o o]}U}v]v}r
}}v]}i]uvvZ]}X
K}]uv}v]}]v]]
.v r
o]}
X
^P]}uv}o] r
v
W
r}v.uouv}u}]v}v}u
}uo}X}}]v
i]u}]]o]} r
}vUZv}}v]}}.Z]v.}Xr
}v.u}o}o ]P] }}]uv}
}}U}v}o]Xr}v.u}}vvuv}
]P]v]U]v}o}]v}
}voXrs].]ouvu
}}_}
]•P]} u}U }X r /vo
]uv}
u}v]}}]v]]]}]vX
rZ]ivuv}u}v]UZ}]]o] r
vP_vEæu>l~u>l<Pu]vXr
Z}]v}]oPuoP]}vZ]Xr
Z}].o]Xru]v]
v]}}.o}U}}o]]}o}]P]}X
K^Zlo]_]P]Ptv
]v]}
]•P]
WPv}u}uv}}^Zlo]_}
]
vvo]•P]X
E
U}]vo]v]}
v}_}
(]}}
]}}
}]P]}U}v]}v(u]}Uuo}
}_]}
o]}v}u}]vuvoU
}]uv}UvPUu]oXK] r
P]} }v]}uo}_]v}

4. æ
Rev. Ciênc. Méd. Biol., Salvador, v.12, especial, p.482-485, dez.2013
^Zlo]_>]s].}^Pv]•P]Wo]}]vv}
}u}vP_vU]u}u}oPu}o}P]
}]
u}uo]}}} r
]uv}}v}_}}r}]}X
K}]uv}]•P]}}u}v. r
u}
v}}}}.]}v]vo} r
]X
^P]}uv}o] r
vW
r}v.u v}}.]}v]vo
}]Xr}v.u}v}u}]vU}}] r
uv}}o}o]P]Xr}v.u]}v]]o]
}˘uv]}Xr}v.u }]v]}
]o]}}]vuvo}}XrZ r
Z}]}}v]}}.o}XrZ}u}
]vuv}}]vUvPoZU
P}uUvo]]v]}]•P]X
K^Zlo]_ ]P]Ptv ]
o}
v_}]vo}]XK
_Zlo]_}]v]]}ov(uPu}}}
}.]}voU .vo]}v}]P]} ]v
]oX
K}i}u}uv} ]}}
]P] ]}r}]}U v(!v]
}]v o}v ]Uv r
(u]}v]]]vv]U(}u. r
]v }u ]v(}u _ uv
X
^P]}uv}o] r
vW
r}v.u}u}]P]}}v}u}}] r
uv}X r Z }vPu PoZU }uU
P]vuvoXr}v.uv}}˘uu} r
vu]vZo}]}Xro r
Pu }ou (v]}vuv} o} } ] r
uv}X r Z] }u } ]P]}U v(uPu }
v]U}ov} ]}}r}]}}
]vX
} .vo }v]r } ^Z r
lo]_}uo}}}uv}}v˘}
}}v]}}]vU}}]vuv}
o]}o]}]}X
KE>h^K
} o]]o] } ^Z r
lo]_Uo] ].} ]P] ]vv r
vPv}]v]•P]}X
KPv]} Dv]o ^• o}} u
^Zlo]_Uo]].}]P]U
o]u!u}uv}]•P]}Wv]v}
v ]Uv]v]}]•P]v}]v
]o}XoPu}Pv]v]} r
v] ]vv]}v] u o} }]}
}u}}(uvX
K^Zlo]_Uo]].}]P]U
(]oo]}Uo]}u]}}] r
P]uv}]}}]}]vvX
W}o]}}u}(v]o }Pv]}U
}(v]}v]}}P]}]}}u}
]vX
}Pv]!uo(vuvov r
}}^Zlo]_Uo] ].} ]P]
o]]v]U (}u}v .U} r
u}v}]}}}.]}v]U.u(} r
} P]iu•uo]v}
.}Pv}]v]•P]}X
Z&ZE/^
>KUXXoX]P]Pu]}•X/vWD]v] ]}
^•X ]!v]P WuG˘}]o]X
_o]U&WEs/^UXXXXırX
Z^/>XP!v]E]}vos]P]ov]^v]]X }ou/v(}u}r
^Pv}]vo]u]}• XXX
]}v_ouW
DZ'Wll```Xv]XP}XlZ}]lv}]lvXZuEX }
uWv}XX
Z^/>XD]v] ]}^•X ]P]^P /vvUX]}v_ r
o uW DZ'Wll}oXXP}Xl}ol]}l(lPZ}z] r
P]zPX(EX}uWP}XX
>>’ZKU’XXUoX]}]}]}}}}oZ}o]v
]•P]}X ZXZv&}o U&}oUXUvXUXrUioXr
XX
&ZZUXDX]P]PWhu˘]P!v]} o}yy/X ZX}oX
X]X UZ]}:v]}UXıUvXUXrUıX
:K/EdKDD/^^/KEKEZ/dd/KEK&,>d,ZKZ’E/ r
d/KE^r~:,KX:}]v}uu]]}v/vv}voXW] r
}:}]v}uu]]}v/vv}voZ}]]XXX^o}U
X ]}v_o uW D Z'Wll```X:}]v}u]]}v]vv}voX}Pl
Z}]ol(}Zz]}vz Z}]ozuvoz }Pzvo}vX
(XE}uWæXX
WE/Z/UXWXoXZlo]]P]PWvo]Pv
}uv]}]uZ}]o}oX^]>KX ZX’X
v(XUZ]}’v}^oUXUvXUXrUX
ZKZ/’h^UZXXWXV^Kh^U&XXX&XKoZ}v(uPuu
v} ]•P]}W vo] }]uv}X ZX >v}ruX v(u -
PuX UZ]]}W}UXUXrUııX
^K/Z^/>/ZE&ZD/ZK^EdZK/ZjZ’/K~^K r
XvoD]o]o]}Z}rv ] r
X ^]u]!v]v(uPuW]}]r^W X^}
Wo}UXXrıX
^Kh^UWXVhsUX^XV^ZZE,/ZU&X/vP} ]v}}u
Pv}}vX ZXW}X^•W•o] U>]}UXUXırıæU
X
t,Kr tKZ>, >d,KZ’E/d/KEXtKZ> >>/E &KZW s
d/ Ed ^& dz ^hDD Zz K& d, s/ E KE Wd/ Ed ^& dz W
]uo]}v(}ZXdZZZW]}]˙^«vPt}l]vPP}
}(t}ooo]v(}Wv^(˙Xt}o,oZKPv]}vU’v r
Wt,KUıX
^u}uXXV
]}uXXX