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. 2021 Apr;92(4):385-394.
doi: 10.1007/s00104-020-01330-4.

[Surgical site infections-Prevention and treatment strategies]

[Article in German]
Rahel Strobel  1 , Martin Kreis  2 , Johannes Christian Lauscher  2
Affiliations

[Surgical site infections-Prevention and treatment strategies]

[Article in German]
Rahel Strobel et al. Chirurg. 2021 Apr.

Abstract
in English, German

Surgical site infections (SSI) are the most frequent nosocomial infection in Germany. They are defined as an infection of the surgical site that occurs within 30 days after a surgical procedure. The diagnostic criteria include localized pain or tenderness, localized swelling, erythema, excess warmth, purulent drainage from the incision and cultural detection of pathogens in an aseptically obtained specimen from the incision. Wound infections are differentiated into superficial incisional (grade 1), deep incisional (grade 2) and infections of organs and body cavities in the region of the operation (grade 3). Risk factors for SSI include anemia, immunosuppression, diabetes mellitus, obesity, smoking and malnutrition. The crucial preoperative preventive measures are antisepsis of the surgical area and antibiotic prophylaxis. Intraoperative subcutaneous wound irrigation with an antiseptic solution reduces SSI in visceral surgery. The primary treatment encompasses the liberal debridement of the wound.

Die postoperative Wundinfektion ist die häufigste nosokomiale Infektion in Deutschland. Sie ist definiert als Infektion der Inzisionsstelle innerhalb von 30 Tagen nach einer Operation. Zu den diagnostischen Kriterien zählen Schmerz, lokalisierte Schwellung, Rötung, Überwärmung, eitrige Sekretion aus einer Wunde oder der kulturelle Nachweis von Erregern aus einem aseptisch entnommenen Wundsekret. Es werden oberflächliche (Grad 1), tiefe (Grad 2) und Infektionen von Organen und Körperhöhlen im Operationsgebiet (Grad 3) unterschieden. Zu den Risikofaktoren zählen Anämie, Immunsuppression, Diabetes mellitus, Adipositas, Nikotinabusus und Mangelernährung. Die entscheidenden präoperativen Präventionsmaßnahmen sind die Antisepsis des Operationsgebietes sowie die Antibiotikaprophylaxe. Eine intraoperative subkutane Spülung mit einem Antiseptikum senkt die Rate postoperativer Wundinfektionen in der Viszeralchirurgie. Die primäre Therapie umfasst die großzügige Eröffnung der Wunde.

Keywords: Antisepsis; Debridement; Pathogen spectrum; Preventive measures; Wound irrigation.

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References

Literatur

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