Comorbilidad y complicaciones en heridas con pérdida de sustancia en miembros inferiores por motocicletas. Hospital Dr. Francisco Icaza Bustamante 2013-2015
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Las heridas con pérdida de sustancia localizadas en miembros inferiores sucedidas durante un accidente de tránsito causado por motocicletas, representan en la actualidad una casuística importante en el área de Cirugía Plástica del Hospital Pediátrico Dr. Francisco Icaza Bustamante. El presente trabajo recopila y evalúa las pautas de manejo empleadas en dicha Institución, tomando en cuenta la existencia de comorbilidad y la presencia de complicaciones, con la finalidad de marcar indicadores que permitan aportar en la realización de un protocolo en el tratamiento de estas lesiones. La investigación fue de tipo correlacional con diseño observacional, retrospectivo, se recolectó la información a través de las historias clínicas de los pacientes del grupo de estudio durante el año 2013-2015. Dentro de los resultados se identificó que la comorbilidad estuvo presente en un 68% (63 casos) de un total de 93 pacientes, predominio de sexo masculino (87%), promedio de edad 7 años. El traumatismo craneoencefálico fue la comorbilidad más observada seguido por la anemia y en menor proporción cardiopatías y hemofilia. No se determinó una relación directa entre la comorbilidad y la presencia de complicaciones, se obtuvo un valor de (p=0,456) lo que prueba la independencia de ambas variables. La principal complicación fue la infección de la herida, siendo el pie la zona anatómica mayormente lesionada, dentro de las opciones de cobertura cutánea evaluadas, el uso de injertos y colgajos obtuvo resultados favorables, mientras que el cierre por segunda intención presentó mayores complicaciones. Se concluye que este estudio muestra similitudes con estadísticas globales.
Wounds with loss of substance localized in the lower limbs occurring during a traffic accident caused by motorcycles, today continue to represent an important casuistry in the area of Plastic Surgery at Children's Hospital Dr. Francisco Icaza Bustamante. This paper compiles and evaluates management guidelines employed in that institution, taking into account the existence of comorbidity and the presence of complications, in order to make indicators to contribute to the realization of a protocol the treatment of these injuries. The research was correlational with observational, retrospective design, information was collected through medical records of patients in the study group during the year 2013-2015. Within results identified that comorbidity was present in 68% (63 cases) of a total of 93 patients, predominance of the male sex (87%), average age of 7 years. The head trauma was the most prevalent comorbidity followed by anemia and to a lesser extent heart disease and hemophilia. A direct relationship between comorbidity and presence of complications were not determined, a value of (p = 0.456) was obtained proving the independence of both variables. The main complication was the infection of the wound, being mostly injured foot the anatomical area, within skin coverage options evaluated, the use of grafts and flaps obtained favorable results, while the second attempt at closure present major complications. It is concluded that this study shows similarities with global statistics.
Wounds with loss of substance localized in the lower limbs occurring during a traffic accident caused by motorcycles, today continue to represent an important casuistry in the area of Plastic Surgery at Children's Hospital Dr. Francisco Icaza Bustamante. This paper compiles and evaluates management guidelines employed in that institution, taking into account the existence of comorbidity and the presence of complications, in order to make indicators to contribute to the realization of a protocol the treatment of these injuries. The research was correlational with observational, retrospective design, information was collected through medical records of patients in the study group during the year 2013-2015. Within results identified that comorbidity was present in 68% (63 cases) of a total of 93 patients, predominance of the male sex (87%), average age of 7 years. The head trauma was the most prevalent comorbidity followed by anemia and to a lesser extent heart disease and hemophilia. A direct relationship between comorbidity and presence of complications were not determined, a value of (p = 0.456) was obtained proving the independence of both variables. The main complication was the infection of the wound, being mostly injured foot the anatomical area, within skin coverage options evaluated, the use of grafts and flaps obtained favorable results, while the second attempt at closure present major complications. It is concluded that this study shows similarities with global statistics.
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COMORBILIDAD, COMPLICACIONES, HERIDAS, PERDIDA DE SUSTANCIA, HOSPITAL DEL NIÑO FRANCISCO DE ICAZA BUSTAMANTE, CANTON GUAYAQUIL, ECUADOR, EXTREMIDAD INFERIOR, ACCIDENTE DE TRANSITO, MOTOCICLETAS