<?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>2695-463X</journal-id>
<journal-title><![CDATA[Revista Española de Podología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev Esp Podol.]]></abbrev-journal-title>
<issn>2695-463X</issn>
<publisher>
<publisher-name><![CDATA[Inspira Network Group, S.L]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2695-463X2025000200135</article-id>
<article-id pub-id-type="doi">10.20986/revesppod.2025.1746/2025</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tratamiento quirúrgico de necrosis del primer dedo por septicemia: caso clínico]]></article-title>
<article-title xml:lang="en"><![CDATA[Surgical treatment of first toe necrosis due to septicemia: clinical case]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Costa Martiniano]]></surname>
<given-names><![CDATA[Joao Miguel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rayo Martín]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rayo Rosado]]></surname>
<given-names><![CDATA[Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-Morilla]]></surname>
<given-names><![CDATA[Sandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rayo Pérez]]></surname>
<given-names><![CDATA[Ana M.ª]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Escola Superior de Saúde da Cruz Vermelha Portuguesa  ]]></institution>
<addr-line><![CDATA[Lisboa ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad de Sevilla Departamento de Podología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Málaga Departamento de Enfermería y Podología ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Spain</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2025</year>
</pub-date>
<volume>36</volume>
<numero>2</numero>
<fpage>135</fpage>
<lpage>138</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S2695-463X2025000200135&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S2695-463X2025000200135&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S2695-463X2025000200135&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El shock séptico es una entidad clínica de alta gravedad caracterizada por hipoperfusión tisular y fallo multiorgánico secundario a una respuesta desregulada frente a una infección. Una de sus complicaciones más devastadoras es la necrosis isquémica distal, que puede conllevar amputaciones y secuelas funcionales severas. En particular, la sepsis meningocócica fulminante puede provocar afectación vascular extensa en las extremidades, originando lesiones irreversibles que impactan negativamente en la deambulación y la calidad de vida. Se presenta el caso de una mujer de 23 años con antecedentes de shock séptico meningocócico, que desarrolló amputación parcial del primer dedo y total del quinto dedo del pie derecho, junto con cicatrices hipertróficas dolorosas y disfunción biomecánica por flexión plantar rígida del hallux. Se planificó una intervención reconstructiva orientada a restablecer la alineación y funcionalidad del antepié, consistente en artrodesis de la articulación metatarsofalángica del primer dedo, remodelado óseo y reconstrucción de tejidos blandos. El seguimiento incluyó controles clínicos, curas periódicas y adaptación de una prótesis de silicona digital, documentándose la evolución clínica y fotográfica hasta el alta definitiva. La reconstrucción del primer radio mediante artrodesis y remodelado quirúrgico, complementada con rehabilitación funcional y soporte protésico permitió recuperar un patrón de marcha ergonómico, eliminar el dolor y mejorar significativamente la función del pie, demostrando la utilidad de un abordaje integral en las secuelas de necrosis isquémica post-sepsis meningocócica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Septic shock is a critical clinical condition characterized by tissue hypoperfusion and multiorgan failure secondary to a dysregulated host response to infection. One of its most devastating complications is distal ischemic necrosis, which may lead to amputations and severe functional sequelae. In particular, fulminant meningococcal sepsis can cause extensive vascular compromise of the extremities, resulting in irreversible lesions that profoundly affect ambulation and quality of life. We report the case of a 23-year-old woman with a history of meningococcal septic shock who developed partial amputation of the first toe and total amputation of the fifth toe of the right foot, accompanied by painful hypertrophic scarring and biomechanical dysfunction due to rigid plantar flexion of the hallux. A reconstructive procedure was planned to restore forefoot alignment and functionality, consisting of arthrodesis of the first metatarsophalangeal joint, bone reshaping, and soft-tissue reconstruction. Postoperative follow-up included regular clinical assessments, periodic wound care, and the adaptation of a custom silicone digital prosthesis, with both clinical and photographic documentation until discharge. Reconstruction of the first ray through arthrodesis and surgical remodeling, complemented by functional rehabilitation and prosthetic support achieved recovery of an ergonomic gait pattern, complete pain relief, and significant improvement in foot function. This case underscores the effectiveness of a comprehensive reconstructive approach in managing ischemic necrosis sequelae following meningococcal sepsis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Shock]]></kwd>
<kwd lng="es"><![CDATA[septicemia]]></kwd>
<kwd lng="es"><![CDATA[tratamiento]]></kwd>
<kwd lng="es"><![CDATA[necrosis]]></kwd>
<kwd lng="es"><![CDATA[isquemia]]></kwd>
<kwd lng="es"><![CDATA[pie]]></kwd>
<kwd lng="es"><![CDATA[dedos]]></kwd>
<kwd lng="es"><![CDATA[artrodesis.]]></kwd>
<kwd lng="en"><![CDATA[Septic shock]]></kwd>
<kwd lng="en"><![CDATA[sepsis]]></kwd>
<kwd lng="en"><![CDATA[treatment]]></kwd>
<kwd lng="en"><![CDATA[necrosis]]></kwd>
<kwd lng="en"><![CDATA[ischemia]]></kwd>
<kwd lng="en"><![CDATA[foot]]></kwd>
<kwd lng="en"><![CDATA[toes]]></kwd>
<kwd lng="en"><![CDATA[arthrodesis]]></kwd>
</kwd-group>
</article-meta>
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<surname><![CDATA[Pinzon]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Baumgarten]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Galetke]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[39-jährige Frau mit schwerer COVID-19-Pneumonie: Erfolgreiches Weaning nach septischem Schock und Vorfußamputation wegen mikrovaskulärer Komplikationen - 39-year-old woman with severe COVID-19 pneumonia: successful weaning after septic shock and forefoot amputation after microvascular complications]]></article-title>
<source><![CDATA[Pneumologie]]></source>
<year>2021</year>
<volume>75</volume>
<numero>7</numero>
<issue>7</issue>
<page-range>526-30</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
