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Aseptisches Operieren in Orthopädie und Unfallchirurgie

Tatsächlicher Stand

Aseptic operations in orthopedics and trauma surgery

Current state of the art

  • Leitthema
  • Published:
Trauma und Berufskrankheit

Zusammenfassung

Hintergrund

Postoperative Wundinfektionen in Unfallchirurgie und Orthopädie sind in einer Ära von technischem Fortschritt und alternder Bevölkerung von besonderer Bedeutung, da sie meist einen komplizierten, langwierigen und teuren Heilungsverlauf verursachen.

Erregerspektrum

Typische Erreger sind Staphylococcus aureus, Biofilm produzierender Staphylococcus epidermidis, hämolysierende Streptokokken und die gramnegativen Stäbchen Escherichia coli und Pseudomonas aeruginosa.

Problematik

Kritische Punkte in der Infektiogenese sind präoperative Hautdesinfektion, Händehygiene, sichere chirurgische Technik, Barrieremaßnahmen zum Schutz vor Erregerverbreitung sowie ein funktionierendes Hygieneregime im Rahmen eines adäquaten Qualitätsmanagements. Die Basisinfektrate in Unfallchirurgie und Orthopädie ist im Vergleich zu anderen chirurgischen Disziplinen höher, nichtsdestotrotz kann durch Implementierung risikoadaptierter Präventionsmaßnahmen eine Verbesserung erzielt werden.

Abstract

Background

Surgical site infections (SSI) in traumatology and orthopedics in the era of increasing technical improvements and an aging and increasingly fragile population are of crucial importance mostly showing complicated, long-term and expensive outcome.

Spectrum of pathogens

Typical wound pathogens of these infections include Staphylococcus aureus, biofilm-producing Staphylococcus epidermidis, hemolytic Streptococci and the Gram-negative rods Escherichia coli and Pseudomonas aeruginosa.

Problems

Critical points in the development of SSI are preoperative skin antisepsis, hand hygiene, safe and skilled technique by surgeons, barrier nursing to prevent spread of pathogens, postoperative wound surveillance and a functioning hygiene regime in the context of an adequate quality management system. Baseline infection incidence in traumatology and orthopedics is inherently higher compared with other surgical disciplines; nevertheless, significant improvements can be achieved by the implementation of risk-adapted infection control measures.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. M. Napp, G. Daeschlein, D. Gümbel, J. Lange, P. Hinz, A. Ekkernkamp geben an, dass kein Interessenkonflikt besteht. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Abteilung für Unfall- und Wiederherstellungschirurgie, Universitätsmedizin Greifswald, Saubruchstraße, 17487, Greifswald, Deutschland

    M. Napp, D. Gümbel, J. Lange, P. Hinz & A. Ekkernkamp

  2. Klinik und Poliklinik für Hautkrankheiten, Universitätsmedizin Greifswald, Greifswald, Deutschland

    G. Daeschlein

  3. Klinik für Unfallchirurgie, Unfallkrankenhaus Berlin, Berlin, Deutschland

    A. Ekkernkamp

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  1. M. Napp
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  2. G. Daeschlein
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  3. D. Gümbel
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  4. J. Lange
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  5. P. Hinz
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Correspondence to M. Napp.

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Napp, M., Daeschlein, G., Gümbel, D. et al. Aseptisches Operieren in Orthopädie und Unfallchirurgie. Trauma Berufskrankh 15, 177–183 (2013). https://doi.org/10.1007/s10039-013-2008-8

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