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Sternumosteomyelitis

Ätiologie, Diagnostik und operative Therapiekonzepte

Sternal osteomyelitis

Etiology, diagnostics and operative therapy concepts

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Zusammenfassung

Die Sternumosteomyelitis stellt ein seltenes Krankheitsbild mit jedoch weitreichenden Konsequenzen für den Patienten dar. Sie tritt mit einer Inzidenz von 0,4–8 % als postoperative Komplikation der medianen Sternotomie im Rahmen kardiochirurgischer Eingriffe auf. Neben chronischen Verläufen mit dem klinischen Bild der nässenden Wunde und Fistelbildungen sind vor allem Wund- und Sternumdehiszenzen zu beobachten. Septische Verläufe mit Mediastinitis bis hin zum septischen Schock sind mit einer hohen Mortalität verbunden und daher eine gefürchtete Komplikationen der Sternuminfektion. Eine frühzeitige Diagnosesicherung und die adäquate chirurgische Therapie sind für die Prognose der Erkrankung entscheidend. Hierdurch lässt sich eine signifikante Verbesserung der Überlebensrate erzielen.

Abstract

Deep sternal infections with sternal osteomyelitis are rare conditions with extensive consequences for the patient. The incidence of complications after median sternotomy is as high as 0.4–8 %. Wound and sternal dehiscence and a septic course with mediastinitis leading to septic shock is a feared complication with a high mortality next to the chronic course of the infection with the clinical correlation of presternal fistulas. An early diagnosis and surgical intervention is decisive to enhance the prognosis of the disease, leading to a significant increase in the survival rate of patients.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. J. Hauser, H.U. Steinau, A. Ring, M. Lehnhardt und D.J. Tilkorn geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Klinik für Plastische, Rekonstruktive und Ästhetische Chirurgie, Handchirurgie, Alfried Krupp Krankenhaus Essen-Steele, Hellweg 100, 45276, Essen, Deutschland

    J. Hauser & D.J. Tilkorn

  2. Klinik für Unfallchirurgie, Plastische- und Rekonstruktive Chirurgie/Handchirurgie, Universitätsklinikum Essen, Essen, Deutschland

    H.U. Steinau

  3. Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgie, Operatives Referenzzentrum für Gliedmaßentumoren, BG Universitätsklinik Bergmannsheil, Ruhr-Universität Bochum, Bochum, Deutschland

    A. Ring & M. Lehnhardt

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  1. J. Hauser
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  2. H.U. Steinau
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  3. A. Ring
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  4. M. Lehnhardt
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  5. D.J. Tilkorn
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Correspondence to J. Hauser.

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Hauser, J., Steinau, H., Ring, A. et al. Sternumosteomyelitis. Chirurg 85, 357–367 (2014). https://doi.org/10.1007/s00104-013-2678-6

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