Plastisch rekonstruktive Mikrochirurgie beim alten Patienten

Zusammenfassung

Ein besseres Verständnis und die zunehmende Routine in der Mikrochirurgie während der letzten zwei Jahrzehnte, unter anderem aufgrund verbesserter Instrumente und technischer Geräte, wie auch die zunehmende Anzahl verfügbarer Gewebe-Spenderstellen für den freien Lappentransfer, ermöglichen heutzutage bei geeigneter Indikation individualisierte, sicherere und erfolgreichere mikrochirurgische Rekonstruktionen nahezu unabhängig vom Patientenalter. Trotz dieser stetigen Entwicklungen ist die Literatur bezüglich der Thematik im Hinblick auf die spezifischen Probleme bei älteren Patienten bisher noch spärlich. In zwei Konsensus-Workshops der DAM (Deutschsprachige Arbeitsgemeinschaft für die Mikrochirurgie der peripheren Nerven und Gefäße) anlässlich der Jahrestagungen 2014 und 2016 wurden die neuesten Erkenntnisse und Erfahrungen zum mikrochirurgischen Wiederaufbau beim älteren Patienten von einer Expertengruppe erarbeitet und aktuelle Empfehlungen formuliert. Basierend auf diesen Konsensus-Treffen und der aktuellen Literatur diskutiert dieser Artikel die relevanten Aspekte.

Abstract

During the last two decades, understanding and experience of microsurgical reconstruction have increased. This is linked to improved instruments and technical devices, as well as to the increased number of available donor sites for microvascular flap transfer. If the indication is appropriate, it is now possible to perform personalised, safe and successful microsurgical reconstructions, almost independently of the patients’ age. Despite these constant developments, there is little specific literature on microsurgery related to the specific problems of the elderly patient. During two consensus workshops organised by the DAM (German Speaking Working Group for Microsurgery of the Peripheral Nerves and Vessels), the latest findings and experience with microsurgical reconstruction in the elderly patient were presented by a group of experts and current recommendations were formulated. On the basis of these consensus workshops and the current literature, this article discusses important issues in this area.

Schlüsselwörter

Mikrochirurgie - Konsensus - alter Patient

Key words

elderly patient - microsurgery elderly - free flap elderly

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