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Offenes Abdomen 2009

Umfrage zu Behandlungsstrategien des offenen Abdomens in Deutschland

Open abdomen 2009

A national survey of open abdomen treatment in Germany

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Zussammenfassung

Hintergrund

Das „offene Abdomen“ (OA) hat sich als Behandlungsstrategie weltweit etabliert. Diese Umfrage eruiert das aktuelle Behandlungsspektrum des OA in deutschen chirurgischen Kliniken.

Material und Methoden

Zwischen Oktober 2008 und September 2009 wurden Daten aus Fragebögen, die an 1219 deutsche chirurgische Kliniken versandt wurden, erhoben und deskriptiv ausgewertet.

Ergebnisse

Der Rücklauf betrug 38% für alle Befragten und 69% für Universitätsklinika. Das Konzept OA setzen 94% ein. In abnehmender Häufigkeit kommen „Etappenlavage“ (87%), kommerzieller Vakuumverband („abdominal dressing“; 82%), „geplante ventrale Hernie“ (69%) und andere intraabdominelle Verbände (z. B. „Vakuum-Pack“ 15%; „Bogotá-Bag“ 5%) zum Einsatz. Knapp die Hälfte (46%) gaben einen Verfahrenswechsel innerhalb der letzten 5 Jahre hin zu abdominellen Vakuumverbänden an.

Schlussfolgerung

Das OA ist in Deutschland weit verbreitet. Ein Methodenwechsel zu Vakuumverfahren zeichnet sich ab. Ob die dominierenden Vakuumverfahren im Vergleich effektiv und sicher sind, muss durch prospektiv kontrollierte Studien untersucht werden. Diese Umfrage liefert hierzu eine Basis für relevante Fragestellungen und institutionelle Vernetzung.

Abstract

Background

Open abdomen (OA) treatment has been established worldwide. This survey examines the current status of OA treatment in Germany.

Material and methods

A national survey was conducted between October 2008 and September 2009 by questionnaires sent to 1,219 surgical departments. Data were evaluated descriptively.

Results

The response rate was 38% overall and 69% for university departments. Open abdomen treatment is used by 94% of all respondents. Most commonly used are staged abdominal lavage (87%), a commercial abdominal dressing system (82%), planned ventral hernia (69%), and other intra-abdominal dressings (e.g. vacuum pack 15%, Bogotá bag 5%). Nearly half of the respondents (46%) indicated a modification of their strategy towards vacuum techniques during the last 5 years.

Conclusions

Open abdomen procedures are widely used in German surgical departments. This survey indicates a shift of treatment strategies towards vacuum techniques but even though predominant, the effectiveness and safety of these techniques must still be confirmed by prospective controlled trials. This survey helps to identify relevant clinical questions and enables focused trial networking.

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Authors and Affiliations

  1. Chirurgische Klinik, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland

    F. Herrle, T. Hasenberg, B. Fini, J. Jonescheit, E. Shang, P. Kienle, S. Post &  M. Niedergethmann

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  1. F. Herrle
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  2. T. Hasenberg
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  3. B. Fini
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  4. J. Jonescheit
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  5. E. Shang
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  6. P. Kienle
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  7. S. Post
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  8. M. Niedergethmann
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Corresponding author

Correspondence to M. Niedergethmann.

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Die Autoren F. Herrle und T. Hasenberg haben zu gleichen Teilen zu der Arbeit beigetragen.

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Herrle, F., Hasenberg, T., Fini, B. et al. Offenes Abdomen 2009. Chirurg 82, 684–690 (2011). https://doi.org/10.1007/s00104-010-2042-z

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