DGI:Perioperative Prophylaxe/Klinisches Bild: Difference between revisions

Latest revision as of 10:33, 27 January 2026

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.

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.

Risikofaktoren für postoperative Wundinfektionen

Patient:inneneigene		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)
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
	intraoperativ	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
	postoperativ	Drainagen >3 Tage Anwendung invasiver medizinischer Technik (z.B. Beatmung, Dialyse, Thoraxdrainage, ZVK, Harnableitung) Re-Operation (z.B. wegen Blutung)

@@ 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
-!Operationskategorie
-!Risiko in %
+'''Risikofaktoren für postoperative Wundinfektionen'''
+{| class="wikitable" style=""
+! colspan="2" |Patient:inneneigene<br />
+|
+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)
 |-
-|Sauber (aseptisch), Klasse  I
+! rowspan="3" |Chirurgische Faktoren
-|saubere Operationen mit Eröffnung des Gastro-, Intestinal-, Urogenital- oder Respirationstraktes ohne Austritt von Inhalt, Operationen an
+!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
-Mucosa und/ oder intertriginösen Arealen
-|1-2%
 |-
-|Sauber-kontaminiert (bedingt aseptisch), Klasse II
+!intraoperativ
+<br />
 |
-saubere Operationen mit Eröffnung des Gastro-, Intestinal-, Urogenital- oder Respirationstraktes ohne Austritt von Inhalt, Operationen an
+*Lange OP-/Interventionsdauer (z.B. >2h)
-Mucosa und/ oder intertriginösen Arealen
-|2-10 %
+*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
 |-
-|Kontaminiert Klasse III
+!postoperativ
-|Operationen bei akuter Entzündung und/ oder Entleerung von Hohlorganinhalt – Durchbrechung der Asepsis bei der Versorgung frischer traumatischer Wunden
+<br />
-|3-15 %
+|
-|-
+*Drainagen >3 Tage
-|Stark kontaminiert (septisch), Klasse IV
-|Operationen bei Eiteransammlung, nach Perforation von Hohlorganen und allen Verletzungen, Wunden, die länger als 4h bestehen
-|Bis 40%
-|-
-|}
-{| class="wikitable"
+*Anwendung invasiver medizinischer Technik (z.B. Beatmung, Dialyse, Thoraxdrainage, ZVK, Harnableitung)
-'''Risikofaktoren für postoperative Wundinfektionen'''
+*Re-Operation (z.B. wegen Blutung)
-{| class="wikitable"
-|+
-!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:
--.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 />
-|-
-|präoperative<br />
-|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 />
-|-
-|intraoperativ<br />
-|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 />
-|-
-|postoperativ<br />
-|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:
--.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 />
 |}
-<br />