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06.03.2025 | Wundinfektion | CME

Vermeidung und Therapie von Wundinfektionen in der Abdominalchirurgie

verfasst von: Tara Mueller-Elmau, Dr. med., Univ.-Prof. Dr. med. Helmut Friess

Erschienen in: Die Chirurgie | Ausgabe 4/2025

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Zusammenfassung

Postoperative Wundinfektionen nach abdominellen Operationen stellen ein relevantes Problem für Patienten und Gesundheitssysteme dar. Neben Pneumonie und Harnwegsinfektion gehören postoperative Wundinfektionen bei diesen Patienten zu den häufigsten nosokomialen Infektionen. Während die patientenbezogenen Risikofaktoren meist nur schwer kurzfristig zu beeinflussen sind, gibt es modifizierbare operationsbezogene Risikofaktoren (z. B. Operationsdauer, sterile Technik, Blutverlust) sowie diverse perioperative Präventionsmaßnahmen mit unterschiedlicher Evidenz (z. B. Hautdesinfektion, intravenöse perioperative Antibiotikaprophylaxe, Verwendung von Bauchfolie, prophylaktische Wundspülung, Wechsel von Instrumentarium und Handschuhen vor Wundverschluss, Triclosan-beschichtetes Nahtmaterial, Unterdruckverband). Je nach Schweregrad und Tiefe der Infektion beinhaltet die Therapie eine Eröffnung der Wunde, operatives Fasziendébridement/VAC-Therapie („vacuum assisted closure-therapy“) oder die Drainage intraabdomineller Abszesse sowie eine intravenöse Antibiotikatherapie. Bei generalisierter Peritonitis ist eine Relaparotomie zur Exploration und Lavage indiziert.
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Metadaten
Titel
Vermeidung und Therapie von Wundinfektionen in der Abdominalchirurgie
verfasst von
Tara Mueller-Elmau, Dr. med.
Univ.-Prof. Dr. med. Helmut Friess
Publikationsdatum
06.03.2025
Verlag
Springer Medizin
Erschienen in
Die Chirurgie / Ausgabe 4/2025
Print ISSN: 2731-6971
Elektronische ISSN: 2731-698X
DOI
https://doi.org/10.1007/s00104-025-02242-x

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