Luzardo-Iglesia B, Ramírez-Lara EJ, Mamani-Choque E

Language: Spanish
References: 12
Page: 1-12
PDF size: 654.53 Kb.

ABSTRACT

Introduction: the skin is the protective barrier of the organism, exposed to aggressions and in particular to burns. The loss of a substantial part of this organ is incompatible with life. The speed and quality of the caumatologist's care are essential factors for the patient's survival.
Objective: to present the case of an extreme critical patient with 95 % of his body surface burned, of interest due to his survival.
Case Presentation: male patient, 31-year-old adult, white, with a history of health. He suffers injuries due to dermohypodermic burns estimated to cover 95 % of the body surface, after a traffic accident. Intensive local and general treatment is carried out, as well as treatment of complications. Occlusive cure, strict hydration per protocol, sister heterograft and zenografts with lyophilized pig skin are applied for temporary covers and serial and opportune autografts as definitive covers. In addition, energetic and correct treatment of the complications with pertinent antibiotic therapy, multidisciplinary attention during its evolution. After 95 days, hospital discharge was decided with outpatient follow-up.
Conclusions: critical burn represents a challenge in the medical field. The holistic way in which he is treated from his admission to his rehabilitation is key to the patient's recovery The current challenge is to reinforce the attention centers to allow the timely delivery of their needs.

REFERENCES

1. Valdés-Mesa S, Palacios-Alfonso I, Mariño-Fernández JA. Presentación de caso. Tratamiento integral del paciente gran quemado. Rev Cub Med Mil [Internet]. 2015 [citado 13 Feb 2015];44(1):130-8. Disponible en: http://scielo.sld.cu/pdf/mil/v44n1/mil16115.pdf

2. Ministerio de Salud (Chile). Guía Clínica. Manejo del paciente gran quemado [Internet]. Santiago de Chile: Minsal; 2016 [citado 13 Feb 2015]. Disponible en: http://www.bibliotecaminsal.cl/wp/wp-content/uploads/2016/04/GPC-GRAN-QUEMADO-FINAL-18-MARZO-2016_DIAGRAMADA.pdf

3. Ministerio de Salud (Chile). Guía Clínica. Gran Quemado. [Internet] Santiago de Chile: Minsal; 2007 [citado 13 Feb 2015]. Disponible en: https://www.minsal.cl/portal/url/item/7222d6a3774f3535e04001011f01482e.pdf

4. Arriagada IC. Manejo multidisciplinario del gran quemado Rev. Med. Clin. Condes [Internet]. 2016 [citado 13 Feb 2015];27(1):38-41] Disponible en: https://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-pdf-S0716864016000079

5. Borges-Muñío H. Manual de procedimientos diagnóstico y tratamiento en caumatología y cirugía plástica. La Habana: Pueblo y Educación; 1984:25-33.

6. Burgos-Frías N. Estudio predictivo de las necesidades transfusionales del paciente quemado quirúrgico y validación del método [Internet]. Madrid: Universidad Autónoma de Madrid; 2017 [citado 13 Feb 2015]. Disponible en: https://repositorio.uam.es/bitstream/handle/10486/681591/burgos_frias_natalia.pdf?sequence=1

7. Calderón-Martínez JC. Quemaduras: principales complicaciones y factores relacionados. [Internet]. Veracruz: Universidad Veracruzana; 2014 [citado 13 Feb 2015]. Disponible en: https://www.uv.mx/blogs/favem2014/files/2014/06/PROTOCOLO-Cesar.pdf

8. Sánchez-Sánchez M, García de Lorenzo-Mateos AM. Fluidoterapia en los pacientes quemados críticos [Internet]. Barcelona: Fresenius Kabi España; 2008 [citado 13 Feb 2015]. Disponible en: http://www.univermedios.com/wp-content/uploads/2018/08/FLUIDOTERAPIA-EN-LOS-PACIENTES-QUEMADOS-CR%C3%8DTICOS.pdf

9. Pérez-Boluda M, Lara-Montenegro J, Ibáñez-Mata J, Cagigal-González L, León-Llerena CM. Guía de actuación ante el paciente quemado [Internet]. Málaga: Hospital Regional Universitario Carlos Haya; 2006 [citado 13 Feb 2015]. Disponible en: https://es.slideshare.net/azanero33/paciente-quemado-3091216

10. García-Urquijo A, Rodríguez-Rodríguez J, Rodríguez-Pérez R, Lorenzo-Manzanas R, Hernández-González G. Staphylococcusaureusen quemaduras: estudio de incidencia, tendencia y pronóstico. Cir. plast. Iberolatinoam [Internet]. 2015 [citado 19 Ago 2015];41(2):127-34. Disponible en: http://scielo.isciii.es/pdf/cpil/v41n2/original2.pdf

11. Moya-Rosa EJ, Moya-Corrales Y, Mesa-Gutiérrez A. Diagnóstico por estudio bacteriológico cuantitativo de la infección en la herida por quemadura. AMC [Internet]. 2020 [citado 13 Feb 2015];24(1):89-99. Disponible en: http://scielo.sld.cu/pdf/amc/v24n1/1025-0255-amc-24-01-e6711.pdf

12. Khaliq MF, Noorani MM, Siddiqui UA, Al Ibran E, Rao MH. Factors associated with duration of hospitalization and outcome in burns patients: a cross sectional study from Government Tertiary Care Hospital in Karachi, Pakistan. Burns [Internet]. 2013 [citado 03 Dic 2019];39(1):[aprox. 5 p.]. Disponible en: https://www.clinicalkey.es/service/content/pdf/watermarked/1-s2.0-S0305417912001258.pdf?locale=es_ES&searchIndex