Zusammenfassung
Postoperative Wundinfektionen (WI) sind in chirurgisch ausgerichteten Abteilungen ein essenzielles Problem im Hinblick auf Morbidität und Mortalität des Patienten. Die WI stellen die dritthäufigste nosokomiale Infektion dar. Die daraus resultierende längere Verweildauer führt zu einer deutlichen Erhöhung der Behandlungskosten.
Die relativ hohe Rate von WI in der Viszeralchirurgie begründet sich in der Spezifität der Eingriffe. Für den ausgedehnten viszeralchirurgischen Eingriff bleibt auch in naher Zukunft die Laparotomie der Standard. Die meist notwendige Eröffnung von Hohlorganen und die damit einhergehende Kontamination bleiben für das Auftreten von WI ein Problem. Mit Entwicklung der minimalinvasiven chirurgischen Techniken und eines immer umfassenderen Wundmanagements konnten in den letzten Jahren gute Ergebnisse hinsichtlich der WI erzielt werden.
Das zeitige Erkennen aller Arten von Wundinfektionen hat für den postoperativen Behandlungsverlauf große Bedeutung. Die Standardisierung etwaiger Komplikationen und eine damit verbundene Therapieeinleitung sind daher unablässig. Die entwickelten Definitionen und Klassifikationen sind hilfreich.
In großen Studien zur Surveillance postoperativer Wundinfektionen werden Methoden aufgezeigt, die eine Einschätzung des eigenen postoperativen Wundinfektionsrisikos zulassen.
Abstract
Postoperative wound infections (WI) in surgically oriented departments are a major problem regarding morbidity and mortality of the patient. They represent the third most nosocomial infection.
Consequently, the prolonged duration of stay in the hospital leads to a significant increase of treatment costs.
The relatively high rate of WI in visceral surgery is due to the specific nature of the performed procedures. For the near future, the standard for broad inverventions (operations) will remain to the laparatomy. The usually necessary opening of visceral organs and the consecutive contamination remain the common cause of WI. During the last years, significantly lower rates of WI were achieved by developing minimally invasive surgical techniques and more elaborated wound management. The early recognition of all types of WI is of great importance to the postoperative healing process. Standardizing possible complications and related treatment guidelines are therefore inevitable.
The existing definitions and classifications are helpful. In broad surveillance studies of postoperative wound infections methods are shown which allow the estimation of the individual risk of developing WI.
Schlüsselwörter
Wundinfektionen - Surveillance - nosokomiale Infektionen - Infektionsmanagement - Oberflächeninfektion
Key words
Wound infection - surveillance - nosocomial infection - management of infection - incisional infection
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P. Stübs
Klinik für Chirurgie · Medizinische Fakultät der Otto-von-Guericke-Universität
Leipziger Straße 44
39120 Magdeburg
Phone: 03 91/6 71 55 00
Fax: 03 91/6 71 55 70
Email: patrick.stuebs@medizin.uni-magdeburg.de
