imported>Bestem |
imported>Kristina.jozic |
| (24 intermediate revisions by 3 users not shown) |
| Line 1: |
Line 1: |
| ==Klinisches Bild==
| | Die Indikation für alle Operationen, die in dieser Handlungsempfehlung aufgelistet sind, sollten mit den chirurgischen Abteilungen konsentiert sein und keiner weiteren Rücksprache bedürfen. Müssen Abweichungen vorgenommen werden, sind diese mit den jeweiligen Operateur:innen im Vorfeld abzusprechen. |
| <br />
| | |
| {| class="wikitable"
| | Die Hauptindikation der PAP sind sauber-kontaminierte bzw. kontaminierte Eingriffe. Bei den meisten aseptischen Eingriffen, ausgenommen Implantationen von größerem Fremdmaterial und herzchirurgische Eingriffe, ist keine PAP nötig. Bei stark kontaminierten (septischen) Eingriffen ist eine Therapie sinnvoll. |
| |+
| | |
| !Eingriffe nach Infektionsrisiko<br />
| |
| !Operationskategorie<br />
| |
| !Risiko in %<br />
| |
| |-
| |
| |Sauber (aseptisch), Klasse I<br />
| |
| |aseptische Operationen ohne Eröffnung des Gastro-, Intestinal- oder Respirationstraktes<br />
| |
| |1-2 %<br />
| |
| |-
| |
| |Sauber-kontaminiert (bedingt aseptisch), Klasse II<br />
| |
| |saubere Operationen mit <span style="letter-spacing:-.15pt">Er</span><span style="letter-spacing:-.1pt">öffnun</span><span style="letter-spacing:-.15pt">g</span> <span style="letter-spacing:-.05pt">de</span><span style="letter-spacing:-.1pt">s</span> <span style="letter-spacing:-.1pt">Ga</span><span style="letter-spacing:-.05pt">stro-, Int</span><span style="letter-spacing:
| |
| -.1pt">e</span><span style="letter-spacing:-.05pt">stinal-,</span> <span style="letter-spacing:-.1pt">Ur</span><span style="letter-spacing:-.05pt">o</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">nital-</span> <span style="letter-spacing:-.05pt">oder</span> <span style="letter-spacing:-.15pt">Re</span><span style="letter-spacing:-.1pt">spirationstrakt</span><span style="letter-spacing:-.15pt">es</span> <span style="letter-spacing:-.05pt">ohne</span> <span style="letter-spacing:-.1pt">A</span><span style="letter-spacing:-.05pt">ustritt</span> <span style="letter-spacing:-.05pt">von</span> <span style="letter-spacing:-.05pt">Inhalt,</span> <span style="letter-spacing:-.15pt">Ope</span><span style="letter-spacing:-.1pt">rationen</span> an
| |
| Mucosa und/ oder intertriginösen Arealen<br />
| |
| |2-10 %<br />
| |
| |-
| |
| |Kontaminiert Klasse III<br />
| |
| |Operationen bei <span style="letter-spacing:
| |
| -.1pt">ak</span><span style="letter-spacing:-.05pt">ut</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">r</span> <span style="letter-spacing:-.1pt">E</span><span style="letter-spacing:-.05pt">ntzündun</span><span style="letter-spacing:-.1pt">g</span> <span style="letter-spacing:-.05pt">und/</span> <span style="letter-spacing:-.1pt">ode</span><span style="letter-spacing:-.05pt">r</span> <span style="letter-spacing:-.1pt">E</span><span style="letter-spacing:-.05pt">ntleerun</span><span style="letter-spacing:-.1pt">g</span> <span style="letter-spacing:-.1pt">vo</span><span style="letter-spacing:-.05pt">n</span> <span style="letter-spacing:-.1pt">Ho</span><span style="letter-spacing:-.05pt">hlor</span><span style="letter-spacing:-.1pt">g</span><span style="letter-spacing:-.05pt">aninhalt – Durchbrechung der Asepsis bei der Versorgung frischer traumatischer Wunden</span><br />
| |
| |3-15 %<br />
| |
| |-
| |
| |Stark kontaminiert (septisch), Klasse IV<br />
| |
| |Operationen bei <span style="letter-spacing:
| |
| -.15pt">E</span><span style="letter-spacing:-.1pt">it</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">r</span><span style="letter-spacing:-.15pt">ans</span><span style="letter-spacing:-.1pt">ammlung,</span> <span style="letter-spacing:-.05pt">n</span><span style="letter-spacing:-.1pt">ac</span><span style="letter-spacing:-.05pt">h</span> <span style="letter-spacing:-.15pt">Pe</span><span style="letter-spacing:-.1pt">rforation</span> <span style="letter-spacing:-.05pt">von</span> <span style="letter-spacing:-.15pt">Ho</span><span style="letter-spacing:-.1pt">hlor</span><span style="letter-spacing:-.15pt">g</span><span style="letter-spacing:-.1pt">anen</span> <span style="letter-spacing:-.05pt">und</span> <span style="letter-spacing:-.05pt">allen</span> <span style="letter-spacing:-.1pt">Ve</span><span style="letter-spacing:-.05pt">rletzun</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">n,</span> <span style="letter-spacing:-.1pt">W</span><span style="letter-spacing:-.05pt">unden,</span> die <span style="letter-spacing:-.05pt">län</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">r</span> als 4h <span style="letter-spacing:-.05pt">best</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">hen</span><br /> | |
| |Bis 40%<br />
| |
| |}
| |
|
| |
|
|
| |
|
| '''Risikofaktoren für postoperative Wundinfektionen''' | | '''Risikofaktoren für postoperative Wundinfektionen''' |
| {| class="wikitable" | | {| class="wikitable" style="" |
| |+
| | ! colspan="2" |Patient:inneneigene<br /> |
| !Patienteneigene<br />
| | | |
| !Alter (Zunahme/Dezenium); Diabetes, Immuninkompetenz (z.B. Karzinompatienten), reduzierter Allgemeinzustanz, <span style="letter-spacing:-.1pt">Übe</span><span style="letter-spacing:-.05pt">r</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">wicht,</span> <span style="letter-spacing:-.1pt">M</span><span style="letter-spacing:-.05pt">an</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">lernährung,</span> <span style="letter-spacing:-.15pt">ASA</span><span style="letter-spacing:-.1pt">-</span><span style="letter-spacing:-.15pt">Sco</span><span style="letter-spacing:-.1pt">r</span><span style="letter-spacing:-.15pt">e</span> > 2, <span style="letter-spacing:-.2pt">MSSA/MR</span><span style="letter-spacing:-.25pt">S</span><span style="letter-spacing:-.2pt">A</span><span style="letter-spacing:-.1pt">-</span><span style="letter-spacing:-.25pt">T</span><span style="letter-spacing:-.15pt">r</span><span style="letter-spacing:-.2pt">äge</span><span style="letter-spacing:-.15pt">r,</span> <span style="letter-spacing:-.1pt">F</span><span style="letter-spacing:-.05pt">ieber</span> 1 <span style="letter-spacing:-.1pt">Woc</span><span style="letter-spacing:-.05pt">he</span> <span style="letter-spacing:-.15pt">pr</span><span style="letter-spacing:-.2pt">ä-</span><span style="letter-spacing:-.5pt">O</span><span style="letter-spacing:-.45pt">P</span><span style="letter-spacing:-.3pt">,</span> <span style="letter-spacing:-.05pt">weibliche</span><span style="letter-spacing:-.1pt">s</span> <span style="letter-spacing:-.1pt">Gesc</span><span style="letter-spacing:-.05pt">hle</span><span style="letter-spacing:-.1pt">c</span><span style="letter-spacing:-.05pt">ht bei</span> <span style="letter-spacing:-.15pt">E</span><span style="letter-spacing:-.1pt">in</span><span style="letter-spacing:-.15pt">g</span><span style="letter-spacing:-.1pt">riff</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">n</span> am <span style="letter-spacing:-.1pt">K</span><span style="letter-spacing:-.05pt">olon</span> <span style="letter-spacing:-.05pt">und</span> <span style="letter-spacing:-.05pt">in</span> <span style="letter-spacing:-.05pt">der</span> <span style="letter-spacing:-.15pt">K</span><span style="letter-spacing:-.1pt">ardiochirurgie,</span> <span style="letter-spacing:-.05pt">männliche</span><span style="letter-spacing:-.1pt">s</span> <span style="letter-spacing:-.1pt">Gesc</span><span style="letter-spacing:-.05pt">hle</span><span style="letter-spacing:-.1pt">c</span><span style="letter-spacing:-.05pt">ht</span> <span style="letter-spacing:-.05pt">n</span><span style="letter-spacing:-.1pt">ac</span><span style="letter-spacing:-.05pt">h</span> <span style="letter-spacing:-.25pt">T</span><span style="letter-spacing:-.15pt">raum</span><span style="letter-spacing:-.2pt">a</span><span style="letter-spacing:-.15pt">,</span> <span style="letter-spacing:-.1pt">Gefäßc</span><span style="letter-spacing:-.05pt">hirurgie</span> <span style="letter-spacing:-.05pt">und Kni</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:
| | Zu den patientenspezifischen Faktoren, die das Risiko für postoperative Wundinfektionen erhöhen, zählen insbesondere: hohes Lebensalter, Mangelernährung, Adipositas (BMI>30kg/m²), Diabetes mellitus (insbesondere schlecht eingestellt), Immundefizienz oder Immunsuppression, Malignomerkrankungen, Nieren- oder Leberinsuffizienz, Rauchen sowie Alkohol- und Drogenabusus, Kolonisation mit ''S. aureus'' (MSSA/MRSA), Infektionen außerhalb des OP-Gebiets, periphere Durchblutungsstörungen, Ödeme oder Lymphabflussstörung, Anämie und ASA-Score >II. (nach S3-Leitlinie PAP 2024, Tabelle 8/Abschnitt 3.2.2) |
| -.15pt">ge</span><span style="letter-spacing:-.1pt">lenk</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">r</span><span style="letter-spacing:-.15pt">s</span><span style="letter-spacing:-.1pt">atz,</span> <span style="letter-spacing:-.1pt">Dialys</span><span style="letter-spacing:-.05pt">epatient</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">n,</span> <span style="letter-spacing:-.1pt">Hep</span><span style="letter-spacing:-.05pt">atitis,</span> <span style="letter-spacing:-.15pt">S</span><span style="letter-spacing:-.1pt">tom</span><span style="letter-spacing:-.15pt">a</span><span style="letter-spacing:-.1pt">,</span> <span style="letter-spacing:-.1pt">Dr</span><span style="letter-spacing:-.05pt">o</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">nabusus,</span> <span style="letter-spacing:-.05pt">Inf</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">ktionen</span> <span style="letter-spacing:-.05pt">ander</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">r</span> <span style="letter-spacing:-.15pt">L</span><span style="letter-spacing:-.1pt">okalisationen, AVK</span><span style="letter-spacing:
| | |
| -.05pt">,</span> <span style="letter-spacing:-.05pt">peripher</span><span style="letter-spacing:-.1pt">e</span> <span style="letter-spacing:-.1pt">Öde</span><span style="letter-spacing:-.05pt">me,</span> <span style="letter-spacing:-.15pt">Ly</span><span style="letter-spacing:-.1pt">mphangitis,</span> <span style="letter-spacing:-.1pt">Neu</span><span style="letter-spacing:-.05pt">ropathie,</span> <span style="letter-spacing:-.1pt">Rauc</span><span style="letter-spacing:-.05pt">hen,</span> <span style="letter-spacing:-.15pt">L</span><span style="letter-spacing:-.1pt">ink</span><span style="letter-spacing:-.15pt">s</span><span style="letter-spacing:-.1pt">he</span><span style="letter-spacing:-.15pt">rzve</span><span style="letter-spacing:-.1pt">r</span><span style="letter-spacing:-.15pt">sage</span><span style="letter-spacing:-.1pt">n</span> <span style="letter-spacing:-.05pt">n</span><span style="letter-spacing:-.1pt">ac</span><span style="letter-spacing:-.05pt">h</span> <span style="letter-spacing:-.1pt">koronar</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">m</span> <span style="letter-spacing:-.15pt">By</span><span style="letter-spacing:-.1pt">p</span><span style="letter-spacing:-.15pt">ass, b</span><span style="letter-spacing:-.05pt">akt</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">rielle</span> <span style="letter-spacing:-.15pt">T</span><span style="letter-spacing:-.1pt">ranslokation</span> bei <span style="letter-spacing:-.15pt">L</span><span style="letter-spacing:-.1pt">aparotomie,</span> <span style="letter-spacing:-.1pt">Rheu</span><span style="letter-spacing:-.05pt">matoide</span> <span style="letter-spacing:-.1pt">Ar</span><span style="letter-spacing:-.05pt">thrit</span><span style="letter-spacing:-.1pt">is</span> bei <span style="letter-spacing:-.1pt">K</span><span style="letter-spacing:-.05pt">nie</span><span style="letter-spacing:-.1pt">ge</span><span style="letter-spacing:-.05pt">lenk</span><span style="letter-spacing:-.1pt">se</span><span style="letter-spacing:-.05pt">r</span><span style="letter-spacing:-.1pt">s</span><span style="letter-spacing:-.05pt">atz,</span> <span style="letter-spacing:-.1pt">Z</span><span style="letter-spacing:-.05pt">irr</span><span style="letter-spacing:-.1pt">hos</span><span style="letter-spacing:-.05pt">e; Risikofaktoren in der Dermatochirurgie nach Lokalisation: Bein unterhalb Knie, Leiste, Keilexzision Lippe oder <span style="mso-spacerun:yes"> </span>Ohr,</span> <span style="letter-spacing:-.1pt">Ve</span><span style="letter-spacing:-.05pt">rletzun</span><span style="letter-spacing:-.1pt">g</span> <span style="letter-spacing:-.05pt">der</span> <span style="letter-spacing:-.1pt">Sc</span><span style="letter-spacing:-.05pt">hleimhautbarrier</span><span style="letter-spacing:
| |
| -.1pt">e</span><span style="letter-spacing:-.05pt">,</span> <span style="letter-spacing:-.1pt">L</span><span style="letter-spacing:-.05pt">appenpl</span><span style="letter-spacing:-.1pt">a</span><span style="letter-spacing:-.05pt">stik</span> <span style="letter-spacing:-.05pt">der</span> <span style="letter-spacing:-.1pt">Nase</span><span style="letter-spacing:-.05pt">,</span> <span style="letter-spacing:-.1pt">W</span><span style="letter-spacing:-.05pt">undv</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">r</span><span style="letter-spacing:-.1pt">sc</span><span style="letter-spacing:-.05pt">hlüss</span><span style="letter-spacing:-.1pt">e</span> bei <span style="letter-spacing:-.1pt">2-</span><span style="letter-spacing:-.15pt">z</span><span style="letter-spacing:-.1pt">eiti</span><span style="letter-spacing:-.15pt">ge</span><span style="letter-spacing:-.1pt">m Vor</span><span style="letter-spacing:-.15pt">ge</span><span style="letter-spacing:-.1pt">hen,</span> <span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">ntzündliche</span> <span style="letter-spacing:-.15pt">H</span><span style="letter-spacing:-.1pt">aut</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">rkrankun</span><span style="letter-spacing:-.15pt">ge</span><span style="letter-spacing:-.1pt">n</span><br />
| |
| |- | | |- |
| | colspan="2" |Chirurgische Faktoren<br />
| | ! rowspan="3" |Chirurgische Faktoren |
| | !präoperative |
| | | |
| | *Notfalloperation |
| | |
| | *Rezidiveingriffe |
| | |
| | *Vorbestrahlung |
| | |
| | *Hochrisikooperation |
| | |
| | *Längerer präoperativer Krankenhausaufenthalt |
| | |
| | *Infektion oder Vorschädigung der Haut im OP-Gebiet |
| | |
| | *Suboptimale OP-Vorbereitung (z.B. falscher Zeitpunkt/Art der Haarentfernung) |
| | |
| | *Suboptimale Durchführung der PAP (Auswahl, Zeitpunkt, Dosierung) |
| | |
| | *Fremdkörper-/Implantationsoperation |
| | |
| | *ASA-Score >II |
| | |
| | |
| | |
| |- | | |- |
| |präoperative<br />
| | !intraoperativ |
| |Notfalloperation, längerer präoperativer Krankenhausaufenthalt, falsche Wahl des Antibiotikums <span style="letter-spacing:-.05pt">und</span> <span style="letter-spacing:-.1pt">f</span><span style="letter-spacing:-.15pt">alsc</span><span style="letter-spacing:-.1pt">her</span> <span style="letter-spacing:-.1pt">Z</span><span style="letter-spacing:-.05pt">eitpunkt</span> <span style="letter-spacing:-.05pt">der</span> <span style="letter-spacing:-.1pt">G</span><span style="letter-spacing:-.05pt">abe,</span> <span style="letter-spacing:-.15pt">V</span><span style="letter-spacing:-.1pt">orbe</span><span style="letter-spacing:-.15pt">st</span><span style="letter-spacing:-.1pt">rahlung,</span> <span style="letter-spacing:-.1pt">Hoc</span><span style="letter-spacing:-.05pt">hrisikooperation,</span> <span style="letter-spacing:-.15pt">Re</span><span style="letter-spacing:-.1pt">zidi</span><span style="letter-spacing:-.15pt">v</span><span style="letter-spacing:-.1pt">ein</span><span style="letter-spacing:-.15pt">g</span><span style="letter-spacing:-.1pt">riff</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">,</span> <span style="letter-spacing:-.1pt">S</span><span style="letter-spacing:-.05pt">teine</span> <span style="letter-spacing:-.05pt">im</span> <span style="letter-spacing:-.1pt">G</span><span style="letter-spacing:-.05pt">allen</span><span style="letter-spacing:-.1pt">g</span><span style="letter-spacing:-.05pt">an</span><span style="letter-spacing:-.1pt">g</span> <span style="letter-spacing:-.05pt">oder</span> <span style="letter-spacing:.5pt"> </span><span style="letter-spacing:-.15pt">G</span><span style="letter-spacing:-.1pt">allen</span><span style="letter-spacing:-.15pt">g</span><span style="letter-spacing:-.1pt">an</span><span style="letter-spacing:-.15pt">gsve</span><span style="letter-spacing:-.1pt">rsc</span><span style="letter-spacing:-.05pt">hluß,</span> <span style="letter-spacing:-.1pt">Er</span><span style="letter-spacing:-.05pt">höht</span><span style="letter-spacing:-.1pt">es</span> <span style="letter-spacing:-.45pt">CR</span><span style="letter-spacing:-.4pt">P</span><span style="letter-spacing:-.3pt">,</span> <span style="letter-spacing:-.15pt">F</span><span style="letter-spacing:-.1pt">r</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">mdkörperimplantationen,</span> <span style="letter-spacing:-.1pt">Rasu</span><span style="letter-spacing:-.05pt">r</span> <span style="letter-spacing:-.05pt">nicht</span> <span style="letter-spacing:-.05pt">unmitt</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">lbar</span> <span style="letter-spacing:-.05pt">vor</span> <span style="letter-spacing:-.5pt">O</span><span style="letter-spacing:-.45pt">P</span><span style="letter-spacing:-.3pt">,</span> <span style="letter-spacing:-.1pt">pr</span><span style="letter-spacing:-.15pt">äope</span><span style="letter-spacing:-.1pt">rati</span><span style="letter-spacing:-.15pt">ve</span><span style="letter-spacing:-.1pt">r</span> <span style="letter-spacing:-.1pt">Ur</span><span style="letter-spacing:-.05pt">inkathe</span><span style="letter-spacing:-.2pt">t</span><span style="letter-spacing:-.25pt">e</span><span style="letter-spacing:-.2pt">r,</span> <span style="letter-spacing:-.15pt">v</span><span style="letter-spacing:-.1pt">or</span><span style="letter-spacing:-.15pt">ausgeg</span><span style="letter-spacing:-.1pt">an</span><span style="letter-spacing:-.15pt">ge</span><span style="letter-spacing:-.1pt">ne</span> <span style="letter-spacing:-.1pt">(neur</span><span style="letter-spacing:-.15pt">oc</span><span style="letter-spacing:-.1pt">hirur</span><span style="letter-spacing:-.15pt">gisc</span><span style="letter-spacing:-.1pt">he)</span> <span style="letter-spacing:-.15pt">E</span><span style="letter-spacing:-.1pt">in</span><span style="letter-spacing:-.15pt">g</span><span style="letter-spacing:-.1pt">riff</span><span style="letter-spacing:-.15pt">e</span><br /> | | <br /> |
| | | |
| | *Lange OP-/Interventionsdauer (z.B. >2h) |
| | |
| | *Komplikationen im OP-/Anästhesieverlauf (z.B. Handschuhperforation) |
| | |
| | *Erfahrung und chirurgische Technik des Operateurs |
| | |
| | *Verfahrenswechsel (z.B. von Laparoskopie zu Laparotomie) |
| | |
| | *Implantat-Operation |
| | |
| | *Hypothermie |
| | |
| | *Sauerstoffmangel / Minderperfusion (z.B. Blutverlust) |
| | |
| | *Keine indizierte Nachdosierung der PAP |
| | |
| | *Kontaminierte oder manifest infizierte OP-Region |
| | |
| |- | | |- |
| |intraoperativ<br />
| | !postoperativ |
| |Erfahrung des Chirurgen, OP-Dauer >2h, <span style="letter-spacing:-.05pt">infiziert</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">r</span> <span style="letter-spacing:-.1pt">OP-Be</span><span style="letter-spacing:-.05pt">r</span><span style="letter-spacing:-.1pt">eic</span><span style="letter-spacing:-.05pt">h,</span> <span style="letter-spacing:-.1pt">kontaminiert</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">r</span> <span style="letter-spacing:-.1pt">OP-Be</span><span style="letter-spacing:-.05pt">r</span><span style="letter-spacing:-.1pt">eic</span><span style="letter-spacing:-.05pt">h,</span> <span style="letter-spacing:-.05pt">Bluttransfusion,</span> <span style="letter-spacing:-.1pt">Albuminzufuhr,</span> <span style="letter-spacing:-.05pt">lan</span><span style="letter-spacing:-.1pt">ge</span> <span style="letter-spacing:-.15pt">Anäst</span><span style="letter-spacing:-.1pt">hesied</span><span style="letter-spacing:-.15pt">aue</span><span style="letter-spacing:-.1pt">r,</span> <span style="letter-spacing:-.1pt">Hypothermie</span><span style="letter-spacing:-.05pt">,</span> <span style="letter-spacing:-.1pt">S</span><span style="letter-spacing:-.05pt">auerstoffabfall,</span> <span style="letter-spacing:-.1pt">Un</span><span style="letter-spacing:-.05pt">t</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">rkühlung,</span> <span style="letter-spacing:-.15pt">W</span><span style="letter-spacing:-.1pt">undstapler,</span> <span style="letter-spacing:-.1pt">un</span><span style="letter-spacing:-.15pt">v</span><span style="letter-spacing:-.1pt">orher</span><span style="letter-spacing:-.15pt">se</span><span style="letter-spacing:-.1pt">hbar</span><span style="letter-spacing:-.15pt">e</span> <span style="letter-spacing:-.1pt">K</span><span style="letter-spacing:-.05pt">omplikationen,</span> <span style="letter-spacing:-.15pt">OP-Tec</span><span style="letter-spacing:-.1pt">hnik,</span> <span style="letter-spacing:-.15pt">Ve</span><span style="letter-spacing:-.1pt">rfahr</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">nsw</span><span style="letter-spacing:-.15pt">echse</span><span style="letter-spacing:-.1pt">l</span> <span style="letter-spacing:-.15pt">L</span><span style="letter-spacing:-.1pt">apar</span><span style="letter-spacing:-.15pt">os</span><span style="letter-spacing:-.1pt">kopie/</span><span style="letter-spacing:-.15pt">L</span><span style="letter-spacing:-.1pt">aparotomie,</span> <span style="letter-spacing:-.15pt">E</span><span style="letter-spacing:-.1pt">nt</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">rokokk</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">n,</span> <span style="letter-spacing:-.15pt">E</span><span style="letter-spacing:-.1pt">nt</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">ro</span><span style="letter-spacing:-.05pt">bakt</span><span style="letter-spacing:-.1pt">e</span><span style="letter-spacing:-.05pt">rien,</span> <span style="letter-spacing:-.15pt">Bac</span><span style="letter-spacing:-.1pt">t</span><span style="letter-spacing:-.15pt">e</span><span style="letter-spacing:-.1pt">roide</span><span style="letter-spacing:-.15pt">s</span> <span style="letter-spacing:-.1pt">fr</span><span style="letter-spacing:-.15pt">a</span><span style="letter-spacing:-.1pt">gilis</span> <span style="letter-spacing:-.05pt">in</span> <span style="letter-spacing:-.05pt">der</span> <span style="letter-spacing:-.1pt">W</span><span style="letter-spacing:-.05pt">unde</span><br />
| | <br /> |
| |- | | | |
| |postoperativ<br />
| | *Drainagen >3 Tage |
| |Drainagedauer länger als 3 <span style="letter-spacing:-.3pt">T</span><span style="letter-spacing:-.25pt">age</span><span style="letter-spacing:-.2pt">,</span> <span style="letter-spacing:-.2pt">r</span><span style="letter-spacing:-.25pt">e</span><span style="letter-spacing:-.2pt">spirat</span><span style="letter-spacing:-.25pt">o</span><span style="letter-spacing:-.2pt">r</span><span style="letter-spacing:-.25pt">isc</span><span style="letter-spacing:-.2pt">he</span> <span style="letter-spacing:-.15pt">Sepsis,</span> <span style="letter-spacing:-.2pt">in</span><span style="letter-spacing:-.25pt">vasive</span> <span style="letter-spacing:-.3pt">T</span><span style="letter-spacing:-.25pt">ec</span><span style="letter-spacing:-.2pt">hnik</span><span style="letter-spacing:-.25pt">e</span><span style="letter-spacing:-.2pt">n</span> <span style="letter-spacing:-.25pt">(Ur</span><span style="letter-spacing:-.2pt">inkathet</span><span style="letter-spacing:-.25pt">e</span><span style="letter-spacing:-.2pt">r,</span> <span style="letter-spacing:-.25pt">Tho</span><span style="letter-spacing:-.2pt">r</span><span style="letter-spacing:-.25pt">a</span><span style="letter-spacing:-.2pt">xdrain</span><span style="letter-spacing:-.25pt">age</span><span style="letter-spacing:-.2pt">, Nasenso</span><span style="letter-spacing:-.15pt">nde,</span> <span style="letter-spacing:-.15pt">ZVK),</span> <span style="letter-spacing:
| | |
| -.2pt">Dialyse</span><span style="letter-spacing:-.15pt">,</span> <span style="letter-spacing:-.15pt">frühe</span> <span style="letter-spacing:-.2pt">R</span><span style="letter-spacing:-.15pt">e-Operation</span> <span style="letter-spacing:
| | *Anwendung invasiver medizinischer Technik (z.B. Beatmung, Dialyse, Thoraxdrainage, ZVK, Harnableitung) |
| -.15pt">w</span><span style="letter-spacing:-.2pt">ege</span><span style="letter-spacing:-.15pt">n</span> <span style="letter-spacing:-.15pt">Blutung,</span> <span style="letter-spacing:-.2pt">L</span><span style="letter-spacing:-.15pt">iquorle</span><span style="letter-spacing:-.2pt">c</span><span style="letter-spacing:-.15pt">k</span> <span style="letter-spacing:-.1pt">der</span> <span style="letter-spacing:-.25pt">Z</span><span style="letter-spacing:-.2pt">e</span><span style="letter-spacing:-.15pt">r</span><span style="letter-spacing:-.2pt">e</span><span style="letter-spacing:-.15pt">brospinalflüssi</span><span style="letter-spacing:-.2pt">g</span><span style="letter-spacing:-.15pt">keit,</span> <span style="letter-spacing:-.2pt">e</span><span style="letter-spacing:-.15pt">xterner</span> <span style="letter-spacing:
| | |
| -.25pt">S</span><span style="letter-spacing:-.15pt">hunt</span><br />
| | *Re-Operation (z.B. wegen Blutung) |
| |} | | |} |
| <br />
| |
