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Erschienen in: Der Orthopäde 4/2018

20.03.2018 | Antibiotika | Leitthema

Infektionen nach rekonstruktiven Wirbelsäuleneingriffen

Wie gehe ich damit um?

verfasst von: PD Dr. Burkhard Lehner, Michael Akbar, Nicholas A. Beckmann

Erschienen in: Die Orthopädie | Ausgabe 4/2018

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Zusammenfassung

Grundlagen

Postoperative Wirbelsäuleninfektionen werden bei bis zu 20 % der Patienten beschrieben, sie können schwerwiegende Folgen für den Patienten sowie drastisch erhöhte Behandlungskosten nach sich ziehen. Typische Erreger sind Haut- und Fäkalkeime. Risikofaktoren stellen Adipositas, Diabetes, ein hoher ASA-Wert und intraoperative Komplikationen wie hoher Blutverlust, Duraverletzung sowie wiederholte Operationen dar. Der Prophylaxe mit prä- und perioperativer Minimierung von Risikofaktoren kommt daher eine große Bedeutung zu.

Behandlung

Bei eingetretenem Infekt ist die frühzeitige operative Revision mit Debridement, Lavage und Gewebegewinnung für die mikrobiologische Aufarbeitung zu fordern. Bei frühen Infekten kann meist das Implantat erhalten werden. Adjuvante Maßnahmen, wie die Vakuumtherapie, können den Behandlungserfolg verbessern. Bei späten Infekten ist aufgrund der Biofilmbesiedlung der Implantatoberfläche oder einer Implantatlockerung das Spondylodesematerial zu entfernen und bei noch bestehender Instabilität zu wechseln. Diese Arbeit vermittelt eine Literaturübersicht zur Prophylaxe und Behandlung peri- und postoperativer Infektionen nach rekonstruktiven Wirbelsäuleneingriffen.
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Metadaten
Titel
Infektionen nach rekonstruktiven Wirbelsäuleneingriffen
Wie gehe ich damit um?
verfasst von
PD Dr. Burkhard Lehner
Michael Akbar
Nicholas A. Beckmann
Publikationsdatum
20.03.2018
Verlag
Springer Medizin
Erschienen in
Die Orthopädie / Ausgabe 4/2018
Print ISSN: 2731-7145
Elektronische ISSN: 2731-7153
DOI
https://doi.org/10.1007/s00132-018-3557-0

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Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
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