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Checkliste zur Prävention sternaler Wundinfektionen

Checklist for the prevention of sternal wound infections

  • Übersicht
  • Published:
Zeitschrift für Herz-,Thorax- und Gefäßchirurgie Aims and scope

Zusammenfassung

Sternale Wundinfektionen stellen ernste Komplikationen nach herzchirurgischen Eingriffen dar, gehen mit erhöhter Morbidität und Letalität einher, führen zu einer Verlängerung der Krankenhausverweildauer und verursachen somit zusätzliche Kosten.

Die Strategie zur gezielten Infektionsprävention ist vielschichtig und muss alle Berufsgruppen involvieren, die den herzchirurgischen Patienten betreuen und behandeln. Präoperative Maßnahmen wie Staphylococcus-aureus-/MRSA-Screening, Dekolonisation, Clipping statt Rasur, die korrekte Einhaltung der perioperativen Antibiotikaprophylaxe sowie die intraoperative Blutglukosekontrolle, postoperative Verbandwechsel und eine systematische Überwachung postoperativer Wundinfektionen, Compliancebeobachtungen und Schulungen/Training des medizinischen Personals sind essenzielle Bestandteile eines umfassenden Bündels zur Infektionsprävention, um postoperative Wundinfektionen zu vermeiden. Um nachvollziehbar sicherzustellen, dass diese vielschichtigen prä-, intra- und postoperativen Maßnahmen eingehalten werden, haben sich die Etablierung und der Einsatz einer Checkliste bewährt.

Abstract

Deep sternal wound infections (DSWI) are a severe complication after cardiac surgery. They are associated with higher morbidity and mortality as well as prolonged hospital stay of patients and additional costs. The strategy for specific infection prevention is complex and has to involve all healthcare professionals providing care to patients undergoing cardiac surgery. Preoperative Staphylococcus aureus/MRSA screening, decolonization measures, hair clipping instead of shaving, adherence to perioperative antibiotic prophylaxis, intraoperative blood glucose control, and change of dressings as well as infection control measures (e.g., active surveillance of surgical site infections (SSI), compliance observations, and instruction/training of healthcare professionals) are essential in order to prevent SSI. By implementing and using a checklist, it has already been proven that the complex measures during the pre-, intra-, and postoperative course of events could be reliably reproduced.

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Authors and Affiliations

  1. Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland

    Karolin Graf

  2. BQS Institut für Qualität und Patientensicherheit, Düsseldorf, Deutschland

    K. Doebler, E. Schaefer & J. Koetting

  3. Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland

    A. Haverich

  4. Institut für Hygiene und Umweltmedizin, Charité – Universitätsmedizin Berlin, Berlin, Deutschland

    P. Gastmeier

  5. Deutsche Gesellschaft für Thorax-, Herz- und Gefäßchirurgie, Berlin, Deutschland

    A. Beckmann

Authors
  1. Karolin Graf
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  2. K. Doebler
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  3. E. Schaefer
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  4. J. Koetting
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  5. A. Haverich
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  6. P. Gastmeier
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  7. A. Beckmann
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Correspondence to Karolin Graf.

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Graf, K., Doebler, K., Schaefer, E. et al. Checkliste zur Prävention sternaler Wundinfektionen. Z Herz- Thorax- Gefäßchir 25, 148–153 (2011). https://doi.org/10.1007/s00398-011-0854-x

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  • DOI: https://doi.org/10.1007/s00398-011-0854-x

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