Exposición sobre mordeduras

1. ABORDAJE DE
HERIDAS POR
MORDEDURAS
DIEGO MARIN LIPEDA - I2 U. NORTE
HOSPITAL MILITAR CENTRAL

2. GENERALIDADES
● SE ESTIMA QUE EL 2% DE LA POBLACIÓN ES MORDIDA CADA AÑO
● EL MAYOR PORCENTAJE DE LAS MORDEDURAS SE LE ATRIBUYE A
LOS PERROS Y DEMÁS ANIMALES DE COMPAÑÍA
○ PERROS 60 - 90%
○ GATOS 5-20%
○ HUMANOS 4 - 23%
● LA MORTALIDAD SE CENTRA EN LAS ÁREAS RURALES DISPERSAS
Y SIN ACCESO A LA SALUD

3. PERROS Pasteurella dagmatis, P.canis,Staphylococcus aureus, S.intermedius,
Streptococci, Moroxellaspp.,Neisseria spp., C.canimorsus, Clostridium spp,
Clostridium tetani, Anaerobios spp
GATOS Pasteurella multocida,aerobios mixtos y anaerobio
ROEDORES Streptobacillus moniliformis,Spirillum minus,Salmonella spp
MONOS Aerobios mixto y anaerobios, Streptococci, Neisseria spp., Haemophilus
influenzae, Herpes simiae (Bvirus)
HUMANOS Viridans streptococci, S.pyogenes, S.aureus, Anaerobes, Eikenella
corrodens,hepatitis ByC, virus de la inmunodeficiencia humana
ASPECTOS MICROBIOLÓGICOS

4. CARACTERÍSTICAS DE LA MORDEDURAS

5. ADECUADA INSPECCIÓN DE LA HERIDA
A I O
Adecuar un sitio
con insumos e
iluminación
Inspeccionar con
minucia e irrigar
abundantemente
la herida
Objetivar la
profundidad de la
herida y el daño a
tejidos blandos

6. ADECUADA INSPECCIÓN DE LA HERIDA
U E D
Ubicar y retirar la
presencia de
cuerpos extraños
Evaluar función
de mecanismos
flexores y
extensores
Definir necesidad
de manejo
quirúrgico urgente

7. HERIDAS SIN INDICACIÓN DE CIERRE
TEMPRANO
● HERIDAS PUNZANTES
● HERIDAS EN LAS MANOS, LOS PIES, EL PERINÉ O LOS GENITALES
● HERIDAS QUE TIENEN VARIAS HORAS DE EVOLUCIÓN
● HERIDAS MUY CONTAMINADAS
● HERIDAS MUY EDEMATIZADAS
● HERIDAS QUE MUESTRAN SIGNOS DE INFLAMACIÓN
● HERIDAS QUE INVOLUCRAN ESTRUCTURAS PROFUNDAS (P. EJ.,
TENDONES, CARTÍLAGOS, HUESOS)
● HERIDAS POR MORDEDURAS HUMANAS
● HERIDAS EN AMBIENTES CONTAMINADOS (P. EJ., MARINO, CAMPO,
CLOACAS)

8. EXPOSICIÓN
RABICA

10. MORDEDURA DEL PELEADOR
COMÚN EN LA
PARTE DISTAL DEL
3ER, 4TO Y 5TO
METACARPIANO

11. EVALUACIÓN Y MANEJO DE LA MANO
La mano debe examinarse con los dedos totalmente flexionados para reproducir la
orientación de la piel, los tendones y las articulaciones en el momento del impacto.
• Tratamiento
1. Explorar herida en quirófano.
– El 75 % tenía lesiones en las capas profundas de los tejidos, incluido el tendón, la
cápsula y el hueso.
– El 22% tenía afectación de cartílagos y huesos.
– Los hallazgos destacan la importancia de la exploración quirúrgica y el
desbridamiento.
2. Irrigue la articulación y desbride los bordes de la herida.
3. Dejar cerrar por segunda intención o después de 7 días de cambios de apósito.
4. Antibióticos intravenosos (AMPICILINA+SULB O CLINDA+ CYPRO)
5. Comenzó una discreta movilización después de 48-72 horas.
6. Enviar al paciente a casa con antibióticos esquemas 15 dias.

12. USO DE AYUDAS COMPLEMENTARIA
Las radiografías son
esenciales. Busque un
fragmento de diente, una
fractura de la cabeza del
metacarpiano o aire en la
articulación.
Descartar respuestas agudas
a la infección/ bacteriemia y
anemización
RX
HEMATICO
CULTIVOS

13. PROFILAXIS EN MORDEDURAS
PROFILAXIS
ATB
TETANICA
RABICA
A criterio
clinico
5 años
inmunidad
De Acuerdo a
exposición
01
02
03

14. ● Mordeduras en cara, manos, pies o área genital.
● Heridas con signos de infección.
● Consulta médica retrasada más de 12 horas después de la mordedura.
● Heridas moderadas o graves, especialmente si hay edema, lesión por
aplastamiento o requieren desbridamiento quirúrgico.
● Heridas penetrantes o profundas, especialmente si afectan a hueso, tendones o
articulaciones
● Niños inmunocomprometidos y asplénicos.
● Lactantes en cualquier caso

15. CONSULTA QUIRURGICA
● Aunque la reparación primaria de las heridas por mordedura se
asocia con tasas más altas de infección, todavía se indica para
las lesiones por mordedura donde el resultado estético es
importante.
○ CARA
○ CUELLO
○ GENITALES
● Se debe realizar seguimiento estricto a las 48 - 72 hrs
● Las tasas de infección aumentan en pacientes en los que se
difiere la conducta

17. INTERVENCIONES
Mercury is the closest
planet to the Sun and
the smallest one in the
Solar System—it’s only a
bit larger than the Moon
Chapter A
Neptune is the
farthest planet
Chapter B
Venus has a
beautiful name
Chapter C
Jupiter is the
biggest planet
Chapter D
Mercury is the
closest planet

18. Book Club Slides for College Infographics
Chapter A Chapter B Chapter C
Page 50 Page 100 Page 150
Neptune is the
farthest planet
from the Sun
Despite being red,
Mars is actually a
cold place
Venus has a
beautiful name
but it’s hot

19. Book Club Slides for College Infographics
Neptune
It’s the farthest
planet from the Sun
Mercury
It’s the closest planet
to the Sun
Venus
It has a beautiful
name
Mars
Despite being red, it
is actually cold
01
02
03
04

20. Book Club Slides for College Infographics
BPERook Summary
Book A Mercury is the closest planet to the Sun
Book B Venus has a beautiful name but it’s hot
Book C Jupiter is the biggest planet of them all
Book D Neptune is the farthest planet from the Sun

21. Book Club Slides for College Infographics
Follow the link in the graph to modify its data and then
paste the new one here. For more info, click here
Venus
Venus has a
beautiful name
but it’s hot
150K
Despite being red, Mars is cold

22. Book Club Slides for College Infographics
Neptune
Neptune is the
farthest planet
Mercury
Mercury is the
closest planet
Venus
Venus has a beautiful
name
Mars
Despite being
red, Mars is cold
20% 40%
70% 10%
Start
End

23. Book Club Slides for College Infographics
Read To Read
Book A
Book B
Book C
It is the closest
planet to the Sun
Despite being red,
Mars is actually cold
Jupiter is the biggest
planet of them all

24. Book Club Slides for College Infographics
Venus
Venus has a beautiful
name but it’s hot
150K
Mars
Despite being red, Mars
is actually cold
234K

25. Book Club Slides for College Infographics
Neptune
Neptune is the
farthest planet
Book
A
Mercury
Mercury is the
closest planet to the
Sun
Book
C
Mars
Despite being red,
Mars is actually cold
Book
B
Venus
Venus has a beautiful
name
Book
D

26. Book Club Slides for College Infographics
Neptune is the
farthest planet
Neptune
Despite being red,
Mars is cold
Mars
Jupiter is the
biggest planet
Jupiter
Venus has a
beautiful name
Venus
150,000
Books

27. Book Club Slides for College Infographics
Mercury is the
closest planet
Venus has a
beautiful name
Mars is actually
a cold place
Neptune is the
farthest planet
1
2
3
4
Jupiter is the
biggest planet
Earth is our
blue planet
Saturn has
many rings
The Sun is at
the center
5
6
7
8
Neptune
Jupiter
Mars
Saturn

28. Book Club Slides for College Infographics
Book Club activities of the week
Hour Mon Tue Wed Thu Fri Sat Sun
10:00
13:00
16:00
18:00

29. Book Club Slides for College Infographics
Book A Book B Book C
Mercury is the
closest planet
Venus has a
beautiful name
Mars is actually
a cold place
Neptune is the
farthest planet
Jupiter is the
biggest planet
Earth is our
blue planet
Saturn has
many rings
The Sun is at
the center
The Moon is
Earth’s satellite

30. Book Club Slides for College Infographics
Chapter A
Chapter B
Chapter C
Mercury is the
smallest planet
Despite being red,
Mars is actually cold
Jupiter is the biggest
planet of them all
Follow the link in the graph to modify its data and then
paste the new one here. For more info, click here

31. Book Club Slides for College Infographics
Book A
Neptune is the
farthest planet
Book C
Mercury is the
closest planet
Book B
Mars is actually a
cold place
Book D
Venus has a
beautiful name
35% 40%
60% 10%

32. Book Club Slides for College Infographics
Venus has a
beautiful name
but it’s hot
150K
Despite being red,
Mars is actually a
cold place
320K
Neptune is the
farthest planet
from the Sun
240K

33. Book Club Slides for College Infographics
Follow the link in the graph to modify its data and then
paste the new one here. For more info, click here
Chapter A
Chapter B
Chapter C
Mercury is the
smallest planet
Despite being red,
Mars is actually cold
Jupiter is the biggest
planet of them all

34. Book Club Slides for College Infographics
Book A
It’s the farthest planet from the Sun
Chapter A
● Jupiter is big
● Venus is hot
● Neptune is far
01
Chapter B
● Mars is cold
● Earth has life
● Mercury is small
02
Chapter C
● Saturn has rings
● Pluto is small
● Earth is our planet
03

35. Book Club Slides for College Infographics
Follow the link in the graph to modify its data and then
paste the new one here. For more info, click here
30%
10%
20%
40%
Chapter A
Neptune is very
far from us
Chapter B
Venus has a
beautiful name
Chapter C
Jupiter is the
biggest planet
Chapter D
Mercury is the
closest planet

36. Book Club Slides for College Infographics
Jane Doe
Neptune is the
farthest planet
Main Info
Birthday 12.08.1992
Contact info jane@freepik.com
Fav. Genre
Thriller
Romance
Drama
3/5
5/5
4/5
Mars is actually a cold place
Venus is really hot
Jupiter is the biggest planet

37. Book Club Slides for College Infographics
Chapter B
Chapter D
Chapter F
Venus has a beautiful
name
Neptune is the
farthest planet
Saturn is a gas giant
and has many rings
02
04
06
Book A
Neptune is really far
away from us
01
03
05
Chapter A
Chapter C
Chapter E
Mercury is the
smallest planet
Despite being red,
Mars is actually cold
Jupiter is the biggest
planet of them all

38. Book Club Slides for College Infographics
70%
Jupiter is the biggest planet of them all
Jupiter
50%
Neptune is the farthest planet
Neptune
Name of the book
Characteristics
Main description
Mercury is the closest planet to the
Sun and the smallest one in the
Solar System—it’s only a bit larger
than the Moon
Author: Jane Doe
Mars
Venus

39. Book Club Slides for College Infographics
Chapter A
Mercury is the
smallest planet
Chapter B
Venus has a
beautiful name
Chapter C
Jupiter is the
biggest planet
Chapter D
Despite being
red, Mars is cold
Book A
Concepts Concepts
Concepts
Concepts

40. Book Club Slides for College Infographics
Jane Doe
Neptune is really far
away from us
Contact info
Phone +34 654 321 211
Contact info jane@freepik.com
Birthday 12.08.1992
Sam Smith
Mercury is the
closest planet
Contact info
Phone +34 654 123 678
Contact info sam@freepik.com
Birthday 23.11.2001

41. Book Club Slides for College Infographics
Book A
Chapter A Chapter B Chapter C
Mercury
Venus
Mars
Jupiter
Neptune
Saturn
Author Genre
Despite being red,
Mars is actually cold
Earth is the beautiful
planet we all live on

42. Book Club Slides for College Infographics
Book A
Despite being red,
Mars is cold
Neptune is the
farthest planet
Mercury is the
closest planet
Jupiter is the biggest
planet of them all
Book B
Earth is our
beautiful planet
Venus has a
beautiful name
The Sun is at the
center of them all
Neptune is the
coldest planet
Book C
Venus is a terribly
hot place
Saturn is a gas giant
and has rings
The Moon orbits
around the Earth
Pluto is now known
as a dwarf planet

43. Books Icon Pack

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