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Stellenwert moderner physikalischer Behandlungsverfahren bei infizierten und kolonisierten Wunden in der Dermatologie

Importance of modern treatment procedures for infected and colonized wounds in dermatology

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Zusammenfassung

In den kommenden Jahren ist eine Zunahme von Patienten mit chronischen Ulkuswunden, aber auch mit Wunden bei Tumorerkrankungen zu erwarten – beides typischerweise Erkrankungen, die eine komplexe Therapie erfordern und zunehmend und über zum Teil lange Strecken ambulant versorgt werden müssen. Damit rücken in den letzten Jahren immer mehr Behandlungsverfahren in den Vordergrund, die nicht nur effektiv sind und gut vertragen werden, sondern auch ambulant problemlos angewandt werden können. Hier liegen die Chancen für die Kaltplasmatherapie, die extrakorporale Stoßwellentherapie (ESWT), die wassergefilterte Infrarot-A-Therapie (wIRA), die Elektrostimulation und auch für die Low-Level-Laser-Therapie (LLLT) als adjuvante Verfahren im Rahmen des multimodalen Behandlungskonzeptes von Problemwunden. Alle Verfahren wirken mindestens indirekt antimikrobiell, was bei Keimbelastungen in der Wunde von Vorteil sein kann. Wie auch die anderen Behandlungsmethoden bei Problemwunden erfordert auch der Erfolg versprechende Einsatz der genannten Methoden große Erfahrung in der Wundheilkunde und weitgehende sowie kontinuierliche interdisziplinäre Diagnostik und Therapie (Wundzentrum).

Abstract

In the coming years increasing numbers of patients with chronic ulcers and tumor wounds are to be expected, both of which are typically multifaceted diseases requiring complex and increasingly long-term ambulatory therapy. Therefore, in recent years special medical emphasis has been placed on efficacious therapies with good tolerability and also suitability regarding feasibility for outpatient treatment. Some of these methods, such as cold plasma therapy, extracorporeal shock wave therapy (ESWT), water-filtered infrared therapy (wIRA), electrostimulation (ES) and low level laser therapy (LLLT) have a good chance of success when applied as an adjuvant method in the multimodal treatment concept for patients with recalcitrant wounds. All of these methods have at least indirect antimicrobial properties which can be advantageous in cases of microbial infiltration of wounds. As for all other methods for treating recalcitrant wounds, the promising application of the aforementioned methods requires great expertise in wound healing together with a broad and continuous interdisciplinary diagnostics and therapy (wound center).

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Interessenkonflikt

G. Daeschlein, S. Lutze, A. Arnold, S. von Podewils und M. Jünger geben an, dass kein Interessenkonflikt besteht.

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  1. Department of Dermatology, Ernst Moritz Arndt University, Sauerbruchstraße, 17489, Greifswald, Deutschland

    G. Daeschlein, S. Lutze, A. Arnold, S. von Podewils & M. Jünger

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Daeschlein, G., Lutze, S., Arnold, A. et al. Stellenwert moderner physikalischer Behandlungsverfahren bei infizierten und kolonisierten Wunden in der Dermatologie. Hautarzt 65, 949–959 (2014). https://doi.org/10.1007/s00105-014-3526-4

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