Wundinfektionen in der Viszeralchirurgie - Ätiologie, Risikofaktoren, Antibiotikaprophylaxe

 

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Zusammenfassung

Nosokomiale Infektionen sind die Hauptursache für Morbidität und Mortalität im Krankenhaus. In Deutschland entwickeln 3,5 % der Patienten nosokomiale Infektionen, wovon 15 % Wundinfektionen nach chirurgischen Eingriffen sind. Asepsis, die adäquate chirurgische Technik und die Erkennung von Patienten mit einem Infektionsrisiko, sowie die adäquate Antibiotikaprophylaxe sind die effektivsten Maßnahmen, um postoperative Wundinfektionen zu reduzieren. Um Patienten mit einem Infektionsrisiko zu identifizieren, genügt die traditionelle Wundklassifikation nicht. Zusätzliche Risikofaktoren, die über die vermutete Keimkontaminationsrate am Ende einer Operation hinausgehen, müssen berücksichtigt werden. Indikation, die Wahl des Antibiotikums und der Applikationszeitpunkt werden aufgrund neuerer Literatur diskutiert.

Abstract

Nosocomial infections are the major cause for morbidity and mortality in hospital. In Germany 3.5 % of patients develope nosocomial infections, 15 % of these are wound infections post surgery. Asepsis, proper surgical technique and identifying patients at risk of infections and antibiotic prophylaxis are the most effective measures to reduce postoperative wound infection rate. To identify patients at risk by traditional wound classification system alone seems to be insufficient. Risk factors others than the suspected contamination rate at the end of the operation have to be detected. Indication, choice of the antibiotic agent and timing of antibiotic prophylaxis will be discussed.

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Prof. Dr. H. Wacha

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