DGI:Perioperative Prophylaxe/Klinisches Bild: Difference between revisions

Revision as of 15:01, 15 June 2021

Klinisches Bild


Eingriffe nach Infektionsrisiko	Operationskategorie	Risiko in %
Sauber (aseptisch), Klasse I	aseptische Operationen ohne Eröffnung des Gastro-, Intestinal- oder Respirationstraktes	1-2 %
Sauber-kontaminiert (bedingt aseptisch), Klasse II	saubere Operationen mit Eröffnung des Gastro-, Intestinal-, Urogenital- oder Respirationstraktes ohne Austritt von Inhalt, Operationen an Mucosa und/ oder intertriginösen Arealen	2-10 %
Kontaminiert Klasse III	Operationen bei akuter Entzündung und/ oder Entleerung von Hohlorganinhalt – Durchbrechung der Asepsis bei der Versorgung frischer traumatischer Wunden	3-15 %
Stark kontaminiert (septisch), Klasse IV	Operationen bei Eiteransammlung, nach Perforation von Hohlorganen und allen Verletzungen, Wunden, die länger als 4h bestehen	Bis 40%

Risikofaktoren für postoperative Wundinfektionen


Patienteneigene	Alter (Zunahme/Dezenium); Diabetes, Immuninkompetenz (z.B. Karzinompatienten), reduzierter Allgemeinzustanz, Übergewicht, Mangelernährung, ASA-Score > 2, MSSA/MRSA-Träger, Fieber 1 Woche prä-OP, weibliches Geschlecht bei Eingriffen am Kolon und in der Kardiochirurgie, männliches Geschlecht nach Trauma, Gefäßchirurgie und Kniegelenkersatz, Dialysepatienten, Hepatitis, Stoma, Drogenabusus, Infektionen anderer Lokalisationen, AVK, periphere Ödeme, Lymphangitis, Neuropathie, Rauchen, Linksherzversagen nach koronarem Bypass, bakterielle Translokation bei Laparotomie, Rheumatoide Arthritis bei Kniegelenksersatz, Zirrhose; Risikofaktoren in der Dermatochirurgie nach Lokalisation: Bein unterhalb Knie, Leiste, Keilexzision Lippe oder Ohr, Verletzung der Schleimhautbarriere, Lappenplastik der Nase, Wundverschlüsse bei 2-zeitigem Vorgehen, entzündliche Hauterkrankungen
Chirurgische Faktoren
präoperative	Notfalloperation, längerer präoperativer Krankenhausaufenthalt, falsche Wahl des Antibiotikums und falscher Zeitpunkt der Gabe, Vorbestrahlung, Hochrisikooperation, Rezidiveingriffe, Steine im Gallengang oder Gallengangsverschluß, Erhöhtes CRP, Fremdkörperimplantationen, Rasur nicht unmittelbar vor OP, präoperativer Urinkatheter, vorausgegangene (neurochirurgische) Eingriffe
intraoperativ	Erfahrung des Chirurgen, OP-Dauer >2h, infizierter OP-Bereich, kontaminierter OP-Bereich, Bluttransfusion, Albuminzufuhr, lange Anästhesiedauer, Hypothermie, Sauerstoffabfall, Unterkühlung, Wundstapler, unvorhersehbare Komplikationen, OP-Technik, Verfahrenswechsel Laparoskopie/Laparotomie, Enterokokken, Enterobakterien, Bacteroides fragilis in der Wunde
postoperativ	Drainagedauer länger als 3 Tage, respiratorische Sepsis, invasive Techniken (Urinkatheter, Thoraxdrainage, Nasensonde, ZVK), Dialyse, frühe Re-Operation wegen Blutung, Liquorleck der Zerebrospinalflüssigkeit, externer Shunt

@@ Line 1: / Line 1: @@
-== Klinisches Bild ==
+==Klinisches Bild==
+<br />
+{| class="wikitable"
+|+
+!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'''
+{| 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 />