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Definition und Management der Wundinfektion

Definition and management of wound infections

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Zusammenfassung

Postoperative Wundinfektionen werden im internationalen Sprachgebrauch zunehmend SSI – „surgical site infections“ – genannt und sind seit jeher das Damoklesschwert der Chirurgie. Trotz Einführung der Asepsis und der Antibiotikatherapie bzw. -prophylaxe in die moderne operative Medizin ist nicht jede Infektion vermeidbar. Mit einem Anteil von 25% sind die Wundinfektionen die zweithäufigste Ursache aller im Krankenhaus erworbenen Infektionen. Sie verursachen bis zu 50% der dadurch entstandenen Kosten. Die Folgen reichen von einem verlängerten Krankenhausaufenthalt bis hin zu erhöhter Mortalität. Zahlreiche Faktoren wirken begünstigend auf die Entstehung einer Wundinfektion. So ist es bekannt, dass der Kontaminationsgrad der Operation eine wesentliche Rolle spielt. Aber auch der Status des Immunsystems sowie die Komorbidität des Patienten sind von Bedeutung. Wichtig in diesem Zusammenhang sind die präoperativen Maßnahmen zur Prävention von Wundinfektionen. Auch während und nach dem operativen Eingriff gibt es einige wesentliche Maßnahmen, die beachtet werden müssen. Kommt es trotz aller Sorgfalt zu einer Infektion, sind rechtzeitiges Erkennen und korrektes Management ausschlaggebend für den weiteren Verlauf. Im Rahmen dieses Artikels sollen die wichtigsten Informationen zur Entstehung, zur Vermeidung und zur Therapie der chirurgischen Wundinfektion dargestellt werden.

Abstract

Surgical site infections (SSI) in the postoperative period represent the sword of Damocles in surgery. In spite of the medical progress in recent years these infections cannot always be avoided and occur in 25% of all nosocomial infections in Germany. They also generate up to 50% of the required costs in this context. The consequences vary from extended duration of hospitalization to elevated mortality. The degree of contamination of surgical wounds is of great importance as well as the patient’s immune status and comorbidities. Prevention of infected surgical wounds is essential and important measures should begin even prior to the surgical procedure. In addition, during and following the surgical procedure several standards have to be followed. Rapid confirmation of diagnosis and correct management of surgical site infections are essential for the course of the disease. This study provides information on development, prevention and therapy of surgically infected wounds.

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Authors and Affiliations

  1. Klinik und Poliklinik für Chirurgie, Abteilung für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsklinikum Greifswald, Friedrich-Loeffler-Str. 23b, 17475, Greifswald, Deutschland

    S. Maier, P. Körner, S. Diedrich &  C.-D. Heidecke

  2. Institut für Hygiene und Umweltmedizin, Universitätsklinikum Greifswald, Greifswald, Deutschland

    A. Kramer

Authors
  1. S. Maier
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  2. P. Körner
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  3. S. Diedrich
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  4. A. Kramer
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  5. C.-D. Heidecke
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Correspondence to C.-D. Heidecke.

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Maier, S., Körner, P., Diedrich, S. et al. Definition und Management der Wundinfektion. Chirurg 82, 235–241 (2011). https://doi.org/10.1007/s00104-010-2012-5

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  • DOI: https://doi.org/10.1007/s00104-010-2012-5

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