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Efectividad de los diferentes tipos de cierre en las mordeduras de perro

Authors: Balsalobre Ortuño, María del Carmen;

Efectividad de los diferentes tipos de cierre en las mordeduras de perro

Abstract

Las mordeduras de perro constituyen un importante problema de salud pública, generando gran cantidad de consultas en los servicios de urgencias y atención primaria, con estudios que demuestran el aumento de su prevalencia durante los últimos años y con las consecuencias sociales, sanitarias y económicas que este aumento lleva asociado. Sin embargo, hoy en día continúa existiendo una gran controversia en cuánto a cuál es el abordaje de tratamiento más recomendado para facilitar el cierre y favorecer la reducción de complicaciones. Tradicionalmente, la OMS recomendaba posponer la sutura como medida para prevenir la rabia y otras infecciones, corriente que actualmente se encuentra en detrimento, predominando la sutura primaria de la herida si el riesgo de infección es bajo, pero sin evidencia de certeza aún disponible. Consideramos de elevada importancia aumentar la evidencia disponible y con este proyecto se pretende resolver esa duda que muchos profesionales se plantean en su práctica diaria. Se realizará un estudio observacional de cohortes prospectivo que compare la efectividad de los tres tipos de cierre posibles: Cierre primario, cierre por segunda intención y cierre diferido, con una duración de 24 meses en los servicios de urgencias y atención primaria del Área de salud 1 (Murcia/Oeste) del Servicio Murciano de Salud. Se necesitará una muestra total de 74 personas que acudan a estos servicios presentando mordeduras de perro. Como medidas de resultado principales se compararán la infección secundaria, el resultado estético y el tiempo necesario de cierre según el tipo de sutura utilizada. Dog bites are an important public health problem, generating a large number of consultations in emergency services and primary care, with studies showing the increase in their prevalence in recent years and the social, health and economic consequences that this increase carries associated. However, today there is still great controversy as to which is the most recommended treatment approach to facilitate closure and favor the reduction of complications. Traditionally, the WHO recommended postponing suturing as a measure to prevent rabies and other infections, a trend that is currently in decline, with primary suturing of the wound predominating if the risk of infection is low, but without certain evidence yet available. We consider it of great importance to increase the available evidence and with this project we intend to resolve that doubt that many professionals raise in their daily practice. An observational study of prospective cohorts will be carried out comparing the effectiveness of the three possible types of closure: primary closure, closure by secondary intention and deferred closure, with a duration of 24 months in the emergency services and primary care of Health Area 1 (Murcia/West) of the Murcian Health Service. A total sample of 74 people who come to these services presenting dog bites will be needed. As main outcome measures, secondary infection, cosmetic outcome and time required for closure will be compared according to the type of suture used.

Keywords

Perro, CDU::6 - Ciencias aplicadas::61 - Medicina::616 - Patología. Medicina clínica. Oncología, :6 - Ciencias aplicadas::61 - Medicina::616 - Patología. Medicina clínica. Oncología [CDU], Efectividad, Infección, Mordeduras, Suturas

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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Average
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