Aktuelles Wund- und Fistelmanagement in der Viszeralchirurgie

Das Auftreten postoperativer Wundinfektionen sowie enterokutaner Fisteln gehört in der Viszeralchirurgie zu den relevantesten Komplikationen und hat daher einen wichtigen Stellenwert im klinischen Alltag. Im Folgenden werden diese beiden Krankheitsbilder erläutert und besonders auf das chirurgische Management eingegangen.

Publication History

Article published online:
02 March 2022

• Literatur

• 1 Behnke M, Hansen S, Leistner M. et al. Nosocomial infection and antibiotic use: a second national prevalence study in Germany. Dtsch Arztebl Int 2013; 110: 627-633 DOI: 10.3238/arztebl.2013.0627. (PMID: 24133543)
• 2 Diener MK, Knebel P, Kieser M. et al. Effectiveness of triclosan-coated PDS Plus versus uncoated PDS II sutures for prevention of surgical site infection after abdominal wall closure: the randomised controlled PROUD trial. Lancet 2014; 384: 142-152 DOI: 10.1016/S0140-6736(14)60238-5. (PMID: 24718270)
• 3 Gastmeier P, Brandt C, Sohr D. et al. Postoperative Wundinfektionen nach stationären und ambulanten Operationen. Ergebnisse aus dem Krankenhaus-Infektions-Surveillance-System (KISS). Bundesgesundheitsbl – Gesundheitsforsch – Gesundheitsschutz 2004; 47: 339-344
• 4 Malone DL, Genuit T, Tracy JK. et al. Surgical site infections: reanalysis of risk factors. J Surg Res 2002; 103: 89-95 DOI: 10.1006/jsre.2001.6343. (PMID: 11855922)
• 5 Correia MI, Waitzberg DL. The impact of malnutrition on morbidity, mortality, length of hospital stay and costs evaluated through a multivariate model analysis. Clin Nutr 2003; 22: 235-239 DOI: 10.1016/s0261-5614(02)00215-7. (PMID: 12765661)
• 6 Kiran RP, El-Gazzaz GH, Vogel JD. et al. Laparoscopic approach significantly reduces surgical site infections after colorectal surgery: data from national surgical quality improvement program. J Am Coll Surg 2010; 211: 232-238
• 7 Chetter IC, Oswald AV, Fletcher M. et al. A survey of patients with surgical wounds healing by secondary intention; an assessment of prevalence, aetiology, duration and management. J Tissue Viability 2017; 26: 103-107 DOI: 10.1016/j.jtv.2016.12.004. (PMID: 28049612)
• 8 Chetter I, Arundel C, Bell K, Buckley H, Claxton K, Corbacho Martin B, Cullum N, Dumville J, Fairhurst C, Henderson E, Lamb K, Long J, McCaughan D, McGinnis E, Oswald A, Goncalves PS, Sheard L, Soares MO, Stubbs N, Torgerson D, Welton N. The Epidemiology, Management and Impact of surgical Wounds Healing by secondary Intention: a Research Programme including the SWHSI Feasibility RCT. Southampton (UK): NIHR Journals Library; 2020
• 9 National Institute for Health and Care Excellence (UK). Surgical site infections: prevention and treatment. 2020 Im Internet (Stand: 30.07.2021): https://pubmed.ncbi.nlm.nih.gov/31211539/
• 10 Hollington P, Mawdsley J, Lim W. et al. An 11-year experience of enterocutaneous fistula. Br J Surg 2004; 91: 1646-1651 DOI: 10.1002/bjs.4788. (PMID: 15505866)
• 11 Berry SM, Fischer JE. Classification and pathophysiology of enterocutaneous fistulas. Surg Clin North Am 1996; 76: 1009-1018 DOI: 10.1016/s0039-6109(05)70495-3. (PMID: 8841361)
• 12 Berry SM, Fischer JE. Enterocutaneous fistulas. Curr Probl Surg 1994; 31: 483-566 DOI: 10.1016/0011-3840(94)90037-x. (PMID: 8194374)
• 13 Campos AC, Andrade DF, Campos GM. et al. A multivariate model to determine prognostic factors in gastrointestinal fistulas. J Am Coll Surg 1999; 188: 483-490 DOI: 10.1016/s1072-7515(99)00038-1. (PMID: 10235575)
• 14 Caprilli R, Gassull MA, Escher JC. et al. European evidence based consensus on the diagnosis and management of Crohn’s disease: special situations. Gut 2006; 55 (Suppl. 01) i36-i58 DOI: 10.1136/GUT.2005.081950C. (PMID: 16481630)