Behandlungsalgorithmus von Wundinfektionen an der Wirbelsäule mit ersten Ergebnissen einer retrospektiven Studie zur Behandlung von postoperativen Wundinfektionen mit Vakuumsystemen

Zusammenfassung

Die postoperative Wundinfektion ist eine der häufigsten Komplikationen in der Wirbelsäulenchirurgie. Sie verlängert den Leidensweg des Patienten und stellt oftmals eine große Herausforderung an das gesamte Behandlungsteam dar. Zahlreiche Risikofaktoren sind in der Literatur bereits beschrieben, die es präoperativ zu optimieren gilt, um Infektionen zu vermeiden. Bezüglich der Therapie von Wundinfektionen gibt es bei mangelnder Studienlage keine einheitlichen Richtlinien. Oftmals sind mehrere Revisionen erforderlich, bis eine Wundinfektion zur Ausheilung kommt. Im vorliegenden Artikel wird ein interner Algorithmus zur Behandlung postoperativer Wundinfektionen vorgestellt. Unter Zuhilfenahme der VAC-Therapie bei tiefen Wundinfektionen zeigt sich eine erfolgreiche Infektsanierung vor allem auch im Hinblick auf den Implantaterhalt. Zukünftige Studien können helfen die Therapie der Wundinfektionen weiter zu optimieren, die Anzahl der Revisionen zu senken und allgemeingültige Standards zu entwickeln.

Abstract

Postoperative wound infection is one of the most prevalent complications in spinal surgery. It prolongs the patient's suffering and often presents a great challenge to the entire treatment team. Numerous risk factors have already been described in the literature, which must be optimised preoperatively in order to avoid infections. Regarding the therapy of wound infections, there are no uniform guidelines due to lack of reasonable studies. Often several revisions are necessary until a wound infection has been treated successfully. This article presents an internal algorithm for the treatment of postoperative wound infections. With the help of the VAC therapy for deep wound infections, a successful infection treatment is shown, especially with regard to preservation of the implant. Future studies could help to further optimise the therapy of wound infections, reduce the number of revisions, and develop general standards.

Schlüsselwörter

Wundinfektion - Behandlung - Wirbelsäule - Vakuum-Therapie - Algorithmus

Keywords

wound infection - treatment - spine - vacuum-therapy - algorithm

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