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Behandlung der infizierten Verbrennungswunde

  • Chapter
Verbrennungschirurgie

Zusammenfassung

Begünstigend für eine Infektion bei Verbrennungswunden wirken hohes Patientenalter, Komorbiditäten, Verbrennungsausmaß, und -tiefe, Stromverbrennungen und ein geschädigtes Areal mit hoher Keimbelastung, wie das Perineum. Gleiches gilt für unsachgemäße Kühlung, Wundabdeckung, Zeitmanagement und Volumensubstitution in der Erstversorgung und insuffizientes Wund- und Hygienemanagement in der stationären Phase. Infiziertes Gewebe sollte débridiert und supportiv mit antibiogrammgerechter Antibiose therapiert werden. Zur Diagnosesicherung ist die Gewebeprobe zuverlässiger als der Abstrich. Erst auf saubere Wunden sollte Spalthaut transplantiert werden. Wundinfektionen treten meist erst 10 Tage nach der Verbrennung auf, wobei Pilze und gramnegative Keime das höchste Risiko für einen Transplantatverlust bedeuten. Die Wundinfektion selbst oder ein Transplantatverlust gehen laut Literatur nicht mit einer erhöhten Sterblichkeit einher.

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Authors and Affiliations

  1. Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum Referenzzentrum für Gliedmaßentumoren, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum Ruhr-Universität-Bochum, Bürkle-de-la-Camp-Platz 1, D-44789, Bochum

    Prof. Dr. med. Adrien Daigeler & Univ. Prof. Dr. med. Marcus Lehnhardt

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  1. Prof. Dr. med. Adrien Daigeler
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  2. Univ. Prof. Dr. med. Marcus Lehnhardt
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Editors and Affiliations

  1. BG-Universitätsklinikum Bergmannsheil Bochum, Bochum, Deutschland

    Marcus Lehnhardt

  2. Unfallkrankenhaus Berlin, Berlin, Deutschland

    Bernd Hartmann

  3. Klinikum Nürnberg, Nürnberg, Deutschland

    Bert Reichert

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Daigeler, A., Lehnhardt, M. (2016). Behandlung der infizierten Verbrennungswunde. In: Lehnhardt, M., Hartmann, B., Reichert, B. (eds) Verbrennungschirurgie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54444-6_19

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  • DOI: https://doi.org/10.1007/978-3-642-54444-6_19

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-54443-9

  • Online ISBN: 978-3-642-54444-6

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