<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412018000800554</article-id>
<article-id pub-id-type="doi">10.24245/gom.v86i8.2264</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Fascitis necrotizante en cicatriz de cesárea. A propósito de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Necrotizing fasciitis in the surgical wound. A case report]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Frías-Sánchez]]></surname>
<given-names><![CDATA[Zoraida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pantoja-Garrido]]></surname>
<given-names><![CDATA[Manuel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pantoja-Rosso]]></surname>
<given-names><![CDATA[Francisco Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vico-de Miguel]]></surname>
<given-names><![CDATA[Francisco Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General Santa María del Puerto Servicio de Ginecología y Obstetricia ]]></institution>
<addr-line><![CDATA[Puerto de Santa María Cadiz]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario Virgen Macarena Unidad de Gestión Clínica de Obstetricia y Ginecología ]]></institution>
<addr-line><![CDATA[ Sevilla]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2018</year>
</pub-date>
<volume>86</volume>
<numero>8</numero>
<fpage>554</fpage>
<lpage>559</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412018000800554&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412018000800554&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412018000800554&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La fascitis necrotizante es una infección poco frecuente de los tejidos blandos, caracterizada por un proceso infeccioso agresivo y de rápida extensión que resulta en necrosis de la piel, tejido celular subcutáneo y fascia muscular.  Caso clínico:  Paciente de 25 años, con 41 semanas de embarazo; ingresó a la unidad hospitalaria por trabajo de parto. Pese a la buena evolución de la dilatación cervical, el embarazo finalizó mediante cesárea. Durante el posoperatorio se observaron signos de anemia moderada y para ello se le indicó hierro y vitamina C por vía oral; sin embargo, al tercer día posquirúrgico se evidenció la herida quirúrgica con signos de inflamación intensa y exudado seroso. Tuvo fiebre de 38.1 ºC en las últimas horas; su estado general empeoró significativamente. Los estudios de laboratorio reportaron: leucocitosis, anemia severa, plaquetopenia, hiponatremia, hiperglucemia, acidosis metabólica compensada e hipoxemia. El cultivo del exudado de la herida quirúrgica confirmó una infección por Pseudomonas aeruginosa y Staphylococcus aureus. Se estableció el diagnóstico de fascitis necrotizante. El tratamiento consistió en reapertura de la herida, asepsia y desbridamiento de la piel, tejido celular subcutáneo y fascia muscular. La paciente permaneció cinco días más en la unidad de cuidados intensivos, con oxígeno complementario, apoyo inotrópico, antibióticos por vía intravenosa (imipenem, clindamicina, amikacina) y nutrición parenteral. La evolución fue favorable; no se reportaron complicaciones adicionales y la herida quirúrgica cerró por completo.  Conclusiones: El pronóstico de las pacientes con fascitis necrotizante varía en función del diagnóstico y tratamiento oportunos. La tasa de morbilidad y mortalidad se estima, incluso, en 76%.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Necrotizing fasciitis is a rare soft tissue infection, distinguised by an aggressive and rapidly expanding infectious process, that it results in necrosis of the skin, subcutaneous cellular tissue and muscular fascia.  Clinical case: A 25 years-old patient, with 41 weeks of pregnancy; entered the hospital due to delivery labor. Despite the good evolution of the dilation cervical, the pregnancy was completed by caesarean section. During the postoperative were observed signs of moderate anemia; iron and vitamin C were indicated orally; however, on the third postoperative day, the surgical wound with signs was evidenced of intense inflammation and serous exudate. Observed fever of 38.1 ºC in the last hours; his general condition worsened significantly. Laboratory studies reported: leukocytosis, severe anemia, thrombocytopenia, hyponatremia, hyperglycemia, acidosis compensated metabolism and hypoxemia. The culture of exudate from a surgical wound confirmed an infection by Pseudomonas aeruginosa and Staphylococcus aureus. We established the diagnosis of necrotizing fasciitis. The treatment consisted of reopening of the wound, asepsis and debridement of the skin, subcutaneous cellular tissue and fascia muscular. The patient stayed five more days in the intensive care unit, with complementary oxygen, inotropic support, intravenous antibiotics (imipenem, clindamycin, amikacin) and parenteral nutrition. The evolution was favorable; do not observed complications and the surgical wound closed completely.  Conclusions: The prognosis of patients with necrotizing fasciitis varies according of timely diagnosis and treatment. The morbimortality rate it is estimated, even, at 76%.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Fascitis necrotizante]]></kwd>
<kwd lng="es"><![CDATA[posparto]]></kwd>
<kwd lng="es"><![CDATA[sepsis]]></kwd>
<kwd lng="es"><![CDATA[infección, embarazo]]></kwd>
<kwd lng="en"><![CDATA[Necrotizing fasciitis]]></kwd>
<kwd lng="en"><![CDATA[Postpartum]]></kwd>
<kwd lng="en"><![CDATA[Sepsis]]></kwd>
<kwd lng="en"><![CDATA[Infection, Pregnancy]]></kwd>
</kwd-group>
</article-meta>
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