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Rekonstruktionsmöglichkeiten infektionsbedingter Defekte

Plastisch-chirurgisches Armamentarium

Reconstruction options for infection-related defects

Plastic surgery armamentarium

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Die Unfallchirurgie Aims and scope Submit manuscript

Zusammenfassung

Hintergrund

In sämtlichen chirurgischen Disziplinen wird das Auftreten von Infektionen seit jeher gefürchtet. Die Plastisch-Rekonstruktive Chirurgie steht vor der Herausforderung, infektionsbedingte Defekte patientenindividualisiert zu behandeln, wofür ein multidisziplinäres Behandlungskonzept erforderlich ist. Ein zufriedenstellender Behandlungserfolg kann nur durch ein radikales Débridement zur Infektsanierung, die Optimierung der Durchblutungssituation, gepaart mit einer gezielten antiinfektiven Therapie und ggf. plastischer Weichteilrekonstruktion, gelingen.

Fragestellung

Der vorliegende Beitrag stellt die aktuellen Möglichkeiten der Plastischen und Rekonstruktiven Chirurgie im Hinblick auf die Rekonstruktion von infektionsbedingten Defekten dar.

Material und Methode

Es werden bewährte und zuverlässige Strategien behandelt und durch vielversprechende experimentelle Ansätze ergänzt.

Ergebnisse

Aufgrund der oft allschichtigen, infektionsbedingten Defektsituation – von Epidermis bis Knochenspongiosa – findet zur Rekonstruktion das gesamte Armamentarium der Plastischen und Rekonstruktiven Chirurgie Anwendung.

Schlussfolgerung

Die frühzeitige Einbindung der Plastischen Chirurgie sowie der interdisziplinäre und multimodale Behandlungsansatz haben sich in der Behandlung komplexer Infektionssituationen bewährt.

Abstract

Background

The occurrence of infections has always been feared in all surgical disciplines. Plastic reconstructive surgery faces the challenge of treating infection-related defects on a patient-specific basis, which requires a multidisciplinary treatment concept. Satisfactory treatment success can only be achieved through radical debridement for infection cleansing, optimization of the perfusion situation paired with targeted anti-infective treatment and, if necessary, with soft tissue reconstruction by plastic surgery.

Objective

This article presents the current possibilities of plastic and reconstructive surgery with respect to the reconstruction of infection-related defects.

Material and methods

Proven and reliable strategies are presented and supplemented by promising experimental approaches.

Results

Due to the often multilayered defect situation caused by infections, from the epidermis to cancellous bone, the entire armamentarium of plastic and reconstructive surgery is used for reconstruction.

Conclusion

The early involvement of plastic surgery in the treatment of infections and the interdisciplinary and multimodal treatment approach have proven their worth in the treatment of complex infection situations.

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Authors and Affiliations

  1. Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    Vincent März, Peter M. Vogt & Frederik Schlottmann

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  1. Vincent März
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  2. Peter M. Vogt
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  3. Frederik Schlottmann
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Correspondence to Vincent März.

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Interessenkonflikt

V. März, P. M. Vogt und F. Schlottmann geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Peter Vogt, Hannover

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Der Verlag bleibt in Hinblick auf geografische Zuordnungen und Gebietsbezeichnungen in veröffentlichten Karten und Institutsadressen neutral.

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März, V., Vogt, P. & Schlottmann, F. Rekonstruktionsmöglichkeiten infektionsbedingter Defekte. Unfallchirurgie (2024). https://doi.org/10.1007/s00113-024-01439-9

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