Optimización del manejo de infecciones relacionadas con fracturas:una revisión narrativa de la precisión diagnóstica, el momentoquirúrgico oportuno y la administración de antimicrobianos
DOI:
https://doi.org/10.21142/mecp.2026.1.1.e011Palabras clave:
Fracturas Óseas, Infecciones en las Heridas Quirúrgicas, Osteomielitis, Consenso, AntibacterianosResumen
Esta revisión narrativa sintetiza el manejo contemporáneo de la infección relacionada con fracturas (FRI), con énfasis en reducir el fracaso en las zonas grises diagnósticas y terapéuticas. Resumimos las definiciones de consenso que distinguen criterios confirmatorios de criterios sugestivos y las traducimos en un paquete diagnóstico práctico que integra la evaluación clínica, los marcadores inflamatorios, la imagen selectiva y el muestreo microbiológico e histológico disciplinado. La imagen se plantea como una herramienta para resolver problemas clínicos y no como una prueba aislada para confirmar infección en casos equívocos. Presentamos una matriz de decisión quirúrgica basada en el momento de la infección, la fijación y estabilidad de la fractura, los factores del huésped y el estado de los tejidos blandos, e integramos estrategias antimicrobianas locales y sistémicas con principios de optimización del uso de antimicrobianos, incluyendo la toma de muestras antes de iniciar antibióticos cuando sea factible y la desescalada temprana. La calidad de la evidencia es heterogénea y muchas recomendaciones derivan de consensos y datos observacionales; por ello, se destacan las áreas de incertidumbre y las prioridades para estudios prospectivos.
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Derechos de autor 2026 Medical Education & Clinical Practice

Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.


