Manejo de la osteomielitis en heridas del adultos: Aspectos diagnósticos
DOI:
https://doi.org/10.33448/rsd-v13i4.45515Palabras clave:
Diagnóstico; Osteomielitis; Heridas y traumatismos; Adulto; Enfermería; Grupo de atención al paciente.Resumen
Objetivo: desarrollar una guía clínica para un Hospital Universitario Federal de Río de Janeiro, basada en la identificación y análisis científico de los métodos de diagnóstico utilizados para detectar la osteomielitis en heridas de adultos. Metodología: revisión integradora, cuyos criterios de inclusión fueron artículos completos sobre el tema, publicados a partir de 2018, en portugués, español o inglés. Se excluyen estudios con animales, niños menores de 18 años, informes de casos y proyectos. La búsqueda sistemática se realizó mediante Descriptores de Ciencias de la Salud (DeCS) y Medical Subject Heading (MeSH). Resultados: Se identificaron 470 artículos, después de eliminar duplicados y evaluación de dos investigadores, 50 incluidos y analizados, la mayoría de origen estadounidense (34%) y publicados por médicos (96%). En cuanto a las cuestiones diagnósticas, los signos clínicos más citados para la evaluación predictiva fueron los signos de flogosis (54%) y la exposición ósea (40%). Pruebas de laboratorio: cultivo microbiológico (90%), proteína C reactiva (68%) y velocidad de sedimentación globular (68%) compatibles con evaluación infecciosa e inflamatoria. En cuanto a las imágenes, la radiografía lideró con el 70% de las indicaciones de cribado combinada con el signo clínico de percusión ósea, seguida de la resonancia magnética (58%). En cuanto a los exámenes invasivos, la biopsia ósea (82%) apareció como el estándar de oro. Conclusión: con los artículos analizados no fue posible señalar un consenso sobre la jerarquía de los procesos diagnósticos, pero fue posible resaltar recomendaciones clínicas, de laboratorio, de imagen y quirúrgicas que pueden ayudar al enfermero en la práctica clínica a realizar un diagnóstico precoz. remitirlos a otros profesionales, evitando el aumento de la morbilidad y mortalidad por un problema de salud pública.
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Derechos de autor 2024 Vitória Viana Gomes Pinto; Karina Chamma Di Piero; Bruna Maria de Carvalho de Luca Vieira
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