Zusammenfassung
Mittels Wundunterdrucktherapie lassen sich chirurgische, traumatische und chronische Wunden konditionieren. Ihre konzeptionelle, auch großflächige Anwendung insbesondere bei Schwer- und Schwerstbrandverletzten wurde in den vergangen 3 Jahren am Brandverletztenzentrum der Unfallklinik Murnau konsequent verfolgt. Von der Initialversorgung nach Blasendébridement über die Phase der Wundkonditionierung nach Nekrosedébridement bis zur Spalthautübertragung wurden 48 Patienten mit einer brandverletzten Körperoberfläche bis zu 90% mittels Wundunterdrucktherapie behandelt. Intensivmedizinische und chirurgische Parameter der Wundheilung wurden über den gesamten Verlauf des intensivmedizinischen Aufenthalts bestimmt. Bei allen mittels Wundunterdruckverbänden behandelten Patienten konnten unter deutlicher Reduktion der notwendigen Verbandwechsel eine hervorragende Wundkonditionierung, nach Spalthauttransplantation ein rascherer Wundverschluss erreicht werden, zudem waren sie hinsichtlich der intensivmedizinischen und chirurgischen Parameter stabiler. Der konsequente Einsatz der Wundunterdrucktherapie von der Initialversorgung bis zur definitiven Defektdeckung erwies sich somit bislang als exzellentes Therapiekonzept.
Abstract
Negative pressure wound therapy has been used for many years for surgical, traumatic and chronic lesions. During the last 3 years negative pressure wound therapy was consistently pursued as a concept in adults with severe burn injuries in the burn center at the trauma center in Murnau. A total of 48 patients with severe burn injuries to a total body surface area (TBSA) of up to 90% were treated with negative pressure wound therapy. This therapy was used during all stages of treatment from the initial phases of debridement to split thickness skin grafting after debridement. Intensive care parameters and surgical parameters of tissue repair were recorded during the whole intensive care phase. These parameters were compared to data of burn patients who received conservative therapy. All patients with severe burn injuries treated with negative pressure wound therapy showed a significant reduction in redressing. Furthermore, outstanding wound conditioning and excellent take rates after split thickness skin grafting were observed. Intensive care parameters and surgical parameters of wound healing showed patients treated with negative pressure wound therapy were more stable in comparison to patients treated conservatively. Negative pressure wound therapy was shown to be an excellent option especially in the treatment of severe burn patients from initial debridement to final split skin grafting.
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Öhlbauer, M., Wallner, B. & Sauermüller, G. Wundunterdrucktherapie bei Schwerbrandverletzten. Trauma Berufskrankh 13 (Suppl 1), 157–163 (2011). https://doi.org/10.1007/s10039-011-1742-z
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DOI: https://doi.org/10.1007/s10039-011-1742-z