<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2664-3243</journal-id>
<journal-title><![CDATA[Vive Revista de Salud]]></journal-title>
<abbrev-journal-title><![CDATA[Vive Rev. Salud]]></abbrev-journal-title>
<issn>2664-3243</issn>
<publisher>
<publisher-name><![CDATA[CET-BOLIVIA]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2664-32432025000100304</article-id>
<article-id pub-id-type="doi">10.33996/revistavive.v8i22.377</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Relevancia del consentimiento informado en lesión iatrogénica cubital asociada a remoción de implante anticonceptivo]]></article-title>
<article-title xml:lang="en"><![CDATA[Relevance of informed consent in iatrogenic ulnar injury associated with contraceptive implant removal]]></article-title>
<article-title xml:lang="pt"><![CDATA[Relevância do consentimento informado na lesão ulnar iatrogênica associada à remoção de implante contraceptivo]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Flores-Sandí]]></surname>
<given-names><![CDATA[Grettchen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,San José  ]]></institution>
<addr-line><![CDATA[San José ]]></addr-line>
<country>Costa Rica</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2025</year>
</pub-date>
<volume>8</volume>
<numero>22</numero>
<fpage>304</fpage>
<lpage>312</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_arttext&amp;pid=S2664-32432025000100304&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_abstract&amp;pid=S2664-32432025000100304&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.bo/scielo.php?script=sci_pdf&amp;pid=S2664-32432025000100304&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN Los procedimientos de remoción de implantes anticonceptivos están diseñados para realizarse de forma segura, por personal capacitado, en el ámbito ambulatorio con anestesia local, pero pueden ocurrir extracciones difíciles que aumentan el riesgo de lesiones neurológicas, musculares o vasculares y un adecuado consentimiento informado del procedimiento es clave para que la paciente comprenda lo ocurrido. Se debe tener presente que los criterios por los cuales una lesión iatrogénica se considera negligente dependen de los estándares aceptados de la práctica médica y de lo que podría esperarse de las acciones de un médico dada la disponibilidad de pautas y evidencia, así como de los estándares aceptados de atención. Descripción del caso: Paciente que manifestó una reacción iatrogénica caracterizada por sangrado uterino anormal asociado a implante de etonogestrel, y en ausencia de un consentimiento informado del procedimiento presentó lesión del nervio cubital durante el intento fallido de remoción del implante profundo, fue derivada ocho meses después a exploración quirúrgica formal para la remoción del implante y evaluación del nervio cubital. Discusión: La lesión del nervio cubital es una complicación seria y poco común del procedimiento de remoción de estos implantes. Es importante documentar su ubicación precisa antes del procedimiento para minimizar el riesgo, así como realizar un consentimiento informado que incluya riesgos poco frecuentes y contribuya a evitar litigios innecesarios. En su prevención adquiere importancia el entrenamiento adecuado de los profesionales que administran y retiran estos dispositivos, así como la derivación temprana a un centro especializado para prevenir daños permanentes.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Contraceptive implant removal procedures are designed to be performed safely, by trained personnel, in the outpatient setting under local anesthesia, but difficult removals can occur that increase the risk of neurologic, muscular, or vascular injury, and adequate informed consent for the procedure is key to the patient's understanding of what has occurred. It should be kept in mind that the criteria by which an iatrogenic injury is considered negligent depends on accepted standards of medical practice and what might be expected of a physician's actions given the availability of guidelines and evidence, as well as accepted standards of care. Case description: Patient who manifested an iatrogenic reaction characterized by abnormal uterine bleeding associated with etonogestrel implant, and in the absence of informed consent for the procedure presented with ulnar nerve injury during the failed attempt at deep implant removal, was referred eight months later for formal surgical exploration for removal of the implant and evaluation of the ulnar nerve. Discussion: Ulnar nerve injury is a serious and uncommon complication of these implant removal procedures. It is important to document its precise location before the procedure to minimize the risk, as well as to perform an informed consent that includes rare risks and contributes to avoid unnecessary litigation. Adequate training of the professionals who administer and remove these devices is important in their prevention, as well as early referral to a specialized center to prevent permanent damage.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO Os procedimentos de remoção de implantes contraceptivos são projetados para serem realizados com segurança, por pessoal treinado, em ambiente ambulatorial, sob anestesia local, mas podem ocorrer remoções difíceis que aumentam o risco de lesão neurológica, muscular ou vascular, e o consentimento informado adequado para o procedimento é fundamental para que a paciente entenda o que ocorreu. Deve-se ter em mente que os critérios pelos quais uma lesão iatrogênica é considerada negligência dependem dos padrões aceitos de prática médica e do que se pode esperar das ações de um médico, dada a disponibilidade de diretrizes e evidências, bem como dos padrões aceitos de atendimento. Descrição do caso: A paciente que manifestou uma reação iatrogênica caracterizada por sangramento uterino anormal associado ao implante de etonogestrel e, na ausência de consentimento informado para o procedimento, apresentou lesão do nervo ulnar durante a tentativa fracassada de remoção profunda do implante, foi encaminhada oito meses depois para exploração cirúrgica formal para remoção do implante e avaliação do nervo ulnar. Discussão: A lesão do nervo ulnar é uma complicação grave e incomum desses procedimentos de remoção de implantes. É importante documentar sua localização precisa antes do procedimento para minimizar o risco, bem como fornece consentimento informado que inclua riscos raros e ajude a evitar litígios desnecessários. O treinamento adequado dos profissionais que administram e removem esses dispositivos, bem como o encaminhamento precoce a um centro especializado para evitar danos permanentes, é importante para sua prevenção.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Enfermedad Iatrogénica]]></kwd>
<kwd lng="es"><![CDATA[Nervio Cubital]]></kwd>
<kwd lng="es"><![CDATA[Dispositivos Anticonceptivos]]></kwd>
<kwd lng="es"><![CDATA[Consentimiento Informado]]></kwd>
<kwd lng="en"><![CDATA[Iatrogenic Disease]]></kwd>
<kwd lng="en"><![CDATA[Ulnar Nerve]]></kwd>
<kwd lng="en"><![CDATA[Contraceptive Devices]]></kwd>
<kwd lng="en"><![CDATA[Informed Consent]]></kwd>
<kwd lng="pt"><![CDATA[Doença Iatrogênica]]></kwd>
<kwd lng="pt"><![CDATA[Nervo Ulnar]]></kwd>
<kwd lng="pt"><![CDATA[Dispositivos Anticoncepcionais]]></kwd>
<kwd lng="pt"><![CDATA[Consentimento Livre e Esclarecido]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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