Zusammenfassung
In der modernen Wissenschaft vollziehen sich die Wechsel von wissenschaftlichen Paradigmen stetig und oft unbemerkt. Neue Therapieverfahren, deren Effekte mit der bis dahin gültigen Lehrmeinung nicht vereinbar sind, lösen zunächst widersprüchliche Diskussionen aus und führen dann je nach Erkenntnislage zu neuen Lehrmeinungen. Die kontinuierliche computergestützte lokale Unterdrucktherapie (Vakuumtherapie, V.A.C.®, topische negative Druckbehandlung) hat seit ihrer Einführung zu anfangs unerwarteten und beeindruckenden klinischen Ergebnissen geführt, die zu einem erkennbaren Wandel verschiedener therapeutischer Konzepte in der rekonstruktiven Chirurgie geführt haben. Anhand einer Auswahl wichtiger klinischer Beispiele aus der rekonstruktiven Chirurgie wird aufgrund einer aktuellen Literaturrecherche der Versuch unternommen, erkennbare Paradigmenwechsel in den Behandlungsalgorithmen aufzuzeigen, die sich durch die Einführung der Vakuumtherapie in den letzten Jahren abgezeichnet haben.
Abstract
In modern science the changes of scientific paradigm occur constantly and often unnoticed. Effects of new therapy procedures that are not compatible with the prevailing doctrines first lead to contradictory discussions and may then lead to new doctrines depending upon the general perception. Continuous computer-assisted local negative pressure therapy (vacuum assisted closure therapy/V.A.C.®, topical negative pressure treatment) has led to unexpected and impressing clinical results since its introduction. This has provoked a recognizable change of different therapeutic concepts in reconstructive surgery. Based on a selection of important clinical examples from reconstructive surgery following a current literature research the attempt is undertaken to point out recognizable changes of paradigms within the treatment algorithms that can be discerned after the the introduction of vacuum therapy in recent years.
Schlüsselwörter
Paradigmenwechsel - rekonstruktive Chirurgie - Vakuumtherapie
Key words
changing paradigms - reconstructive surgery - vacuum therapy
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Univ.-Prof. Dr. med. R. E. Horch
Abteilung für Plastische und Handchirurgie · Universitätsklinikum Erlangen · Friedrich-Alexander-Universität Erlangen-Nürnberg
Krankenhausstraße 12
91054 Erlangen
Phone: 0 91 31/85/3 32 77
Email: raymund.horch@chir.imed.uni-erlangen.de
