Sepsis secundaria a infección de fracturas expuestas: características clínicas, efecto de la antibioticoterapia y factores pronósticos. Una revisión sistemática.
DOI:
https://doi.org/10.36557/2674-8169.2026v8n9p87-102Palavras-chave:
Sepsis : Fracturas expuestas : Antibioticoterapia : Factores pronósticos : Infección quirúrgica.Resumo
Introducción: Las fracturas expuestas con llevan un alto riesgo de contaminación bacteriana e infección del sitio quirúrgico, las cuales pueden progresar hacia una respuesta inflamatoria sistémica y sepsis grave. Esta complicación compromete la viabilidad de la extremidad y la supervivencia del paciente. Objetivo: Evaluar las características clínicas, la eficacia de la antibioticoterapia y los factores pronósticos determinantes en la sepsis secundaria a infección de fracturas expuestas. Metodología: Se realizó una revisión sistemática de la literatura (2018–2026) en las bases de datos PubMed/MEDLINE, Scopus, Web of Science y The Cochrane Library, siguiendo los lineamientos de la declaración PRISMA y evaluando el riesgo de sesgo mediante la herramienta Cochrane RoB 2. Resultados: Las infecciones polimicrobianas y los patógenos multirresistentes como Staphylococcus aureus resistente a meticilina y Pseudomonas aeruginosa constituyen los principales desencadenantes de sepsis en fracturas expuestas de alta energía Gustilo-Anderson grado III. La administración precoz de antibioticoterapia sistémica combinada con desbridamiento quirúrgico radical reduce significativamente la incidencia de sepsis. Una puntuación elevada en la escala ISS, el retraso quirúrgico superior a 6 horas, el defecto severo de cobertura cutánea y la persistencia de marcadores inflamatorios elevados se identificaron como los principales factores de mal pronóstico. Conclusiones: La sepsis secundaria a fracturas expuestas requiere un manejo multidisciplinario e inmediato. La antibioticoterapia empírica oportuna y dirigida, junto con el control de la fuente infecciosa mediante limpieza quirúrgica, son determinantes fundamentales para prevenir la amputación y reducir la mortalidad.
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Copyright (c) 2026 Yadira Lisseth Mora Campaña, Flavia Elizabeth Cisneros Mediavilla, Carmita Leonor Medina Sucunuta, Luis Patricio Davila Aguilar, Camila Alejandra Barriga Andrade, Stefany Alexandra Rea Navarrete, Sara Noelia Cabrera Jimenez, María de los Angeles Morales Góme
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.
