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Verätzungen und Verbrennungen des Auges

Konservative und chirurgische Optionen einer stadiengerechten Therapie

Chemical and thermal eye burns

Conservatíve and surgical options of a stage-dependent therapy

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Zusammenfassung

Es werden die Grundlagen der medizinischen Versorgung des dringlichen Notfalls Augenverätzung und -verbrennung besprochen. Das Konzept aller Maßnahmen in der Akutphase dient der Verhinderung oder Begrenzung der Gewebezerstörung. Das weitere therapeutische Vorgehen ist auf die Modulation der Entzündungsreaktion, das Abfangen einer bakteriellen Infektion bzw. möglicher Augendrucksteigerungen und auf die Förderung der Wundheilung ausgerichtet. Aus den dargelegten konservativen und chirurgischen Therapieoptionen ist anhand der Klassifikation des Schweregrades der Verätzung sowie einer sorgfältigen Identifizierung zerstörter Gewebestrukturen ein individuelles Maßnahmenkonzept umzusetzen. Bei schweren und schwersten Augenverätzungen gehört hierzu die umfassende chirurgische Sanierung. Die an der Behandlung der Augenverätzung und -verbrennung beteiligten ambulanten und stationären Einrichtungen benötigen ein einheitliches, wissenschaftlich begründetes Therapieregime. Insbesondere ist die lückenlose Fortführung der Behandlung zur Wiederherstellung der Sehkraft entscheidend.

Abstract

The basic principles of first aid for chemical and thermal burns are discussed. In the acute phase the primary goal of all measurements is the prevention or limitation of tissue destruction. The further therapeutic care is focused on the modulation of the inflammatory response, the prevention of a bacterial infection and secondary glaucoma and the stimulation of wound healing. The individual concept of measures to be taken is recruited from the careful identification of necrotic tissue, the eye burn classification of severity and on the basis of all described medical and surgical therapy options. In the case of severe and very severe ocular burns a comprehensive surgical reconstruction is included. All outpatient departments and eye clinics taking part on the treatment have to ensure a standardized complete and scientifically valid therapy regime to restore vision.

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  1. Augenklinik, Martin-Luther-Universität Halle-Wittenberg, E-Grube-Str. 40, 06097, Halle, Deutschland

    H.G. Struck

  2. Augenklinik Köln-Merheim, Kliniken der Stadt Köln gGmbH, Köln, Deutschland

    N.F. Schrage

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Struck, H., Schrage, N. Verätzungen und Verbrennungen des Auges. Ophthalmologe 108, 921–928 (2011). https://doi.org/10.1007/s00347-010-2250-4

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