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Faszienheilungsmöglichkeiten und Platzbauch

Fascial healing and wound failure

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Zusammenfassung

Die Problematik der akuten und der verzögert einsetzenden Wundheilungsstörung der Faszien nach Laparotomieverschluss hat eine unverändert hohe sozioökonomische Relevanz. Trotz einer Vielzahl wissenschaftlicher Untersuchungen der letzten Jahrzehnte ist die Inzidenz von akuten Wunddehiszenzen (Platzbauch) mit 1–3% und Narbenhernien mit 10–15% konstant geblieben. Allgemein akzeptiert ist heute ein multifaktorielles Geschehen mit einer Vielzahl von Einflussfaktoren, so dass zukünftig nur interdisziplinäre Kooperationen diesem komplexen Thema wissenschaftlich gerecht werden. Eine bislang unterschätzte Bedeutung kommt verschiedenen, das Mikroklima der Wunde beeinflussenden Faktoren der Faszienheilung zu. Differenzierte Pharmakotherapie, ein besseres Verständnis der Kollagensynthese und der Dynamik der Nahtspannung sind vielversprechende Ansätze, die in den nächsten Jahren eine Verbesserung der klinischen Situation erhoffen lassen.

Abstract

The difficulties of acute or delayed failure of fascial healing after laparotomies are of great socioeconomic relevance. Despite a plurality of publications in the last decades, the incidence of burst abdomen (1–3%) and incisional hernia (10–15%) remained unchanged. The generally accepted cause is a multifactorial event with a large number of influencing factors. Therefore, only interdisciplinary cooperations are a match for the scientific complexity of this topic. A still underestimated problem is the description of wound healing factors influencing the microclimate in fascial healing. New aspects of pharmacotherapy and better understanding of collagen synthesis and dynamics of closure tension might improve the clinical situation in the future.

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Authors and Affiliations

  1. Chirurgische Universitäts- und Poliklinik, RWTH Aachen

    V. Fackeldey &  U. Klinge

  2. Klinik für Allgemein-, Gefäß- und Viszeralchirurgie, Marienhospital Düsseldorf

    J. Höer

  3. Chirurgische Universitäts- und Poliklinik, RWTH Aachen, Pauwelsstraße 30, 52074 , Aachen

    U. Klinge

Authors
  1. V. Fackeldey
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  2. J. Höer
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  3. U. Klinge
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Correspondence to U. Klinge.

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Fackeldey, V., Höer, J. & Klinge, U. Faszienheilungsmöglichkeiten und Platzbauch. Chirurg 75, 477–483 (2004). https://doi.org/10.1007/s00104-004-0868-y

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