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Mittels Punktion kann eine rasche Schmerzreduktion durch Entlastung von Erg\u00fcssen oder intraartikul\u00e4ren H\u00e4matomen erfolgen. Das gewonnene Punktat erlaubt schon bei der Beschau mit dem freien Auge eine erste Einsch\u00e4tzung und in der Folge eine mikroskopisch-zytologische sowie mikrobiologische Befundung im Labor.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Indikationen<\/jats:title>\n                <jats:p>Die Punktion eines gro\u00dfen Gelenkes ist zur Diagnose und\/oder Therapie bei entz\u00fcndlichen, traumatischen oder postoperativen Gelenksver\u00e4nderungen angezeigt. Diagnostische Punktionen dienen der Punktatgewinnung, der differentialdiagnostischen Schmerzausschaltung oder (selten) der Kontrastmittelapplikation f\u00fcr die Magnetresonanzarthrographie. Therapeutische Punktionen erm\u00f6glichen die Injektion von Medikamenten oder pl\u00e4ttchenreichem Plasma (PRP) sowie die Entlastung bzw. Drainage von Erg\u00fcssen.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Kontraindikationen<\/jats:title>\n                <jats:p>Bei entz\u00fcndlichen und insbesondere eitrigen Hautver\u00e4nderungen im Punktionsbereich sind Gelenkpunktionen kontraindiziert.<\/jats:p>\n                <jats:p>Obwohl keine absolute Kontraindikation, ist bei Einnahme blutgerinnungswirksamer Substanzen Vorsicht geboten.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Operationstechnik<\/jats:title>\n                <jats:p>Besonderes Augenmerk ist auf ein steriles Vorgehen zu legen. Unn\u00f6tige Schmerzen k\u00f6nnen durch das sterile Setzen einer Lokalan\u00e4sthesiequaddel, \u201esichere\u201c Punktionspunkte sowie vorsichtiges Hantieren mit den Punktionskan\u00fclen vermieden werden.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Weiterbehandlung<\/jats:title>\n                <jats:p>Punktate m\u00fcssen entsprechend den lokalen, intrahospitalen Richtlinien zeitgerecht aufgearbeitet bzw. entsorgt werden. Die Punktionsstellen werden mit sterilem Pflasterverband abgedeckt, bei Medikamentenapplikation die Gelenke zur Verteilung des Wirkstoffes passiv durchbewegt. Danach erfolgt eine Kompressionsbehandlung mit elastischer Bandage von distal nach proximal bis \u00fcber die Punktionsstelle zur Vermeidung von Nachblutungen oder sofortiger Ergussneubildung.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Fakten<\/jats:title>\n                <jats:p>Werden s\u00e4mtliche Ma\u00dfnahmen der Sterilit\u00e4t bei der Punktion gro\u00dfer Gelenke eingehalten, ist davon auszugehen, dass Infektionen mit 0,04\u20130,08\u202f% (4 bis 8\/10.000\u00a0Punktionen) nur sehr selten auftreten. Das Risiko f\u00fcr falsch positive Erregernachweise ist \u00e4u\u00dferst gering.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00064-022-00786-3","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T14:03:12Z","timestamp":1673964192000},"page":"65-80","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sterile Punktion gro\u00dfer Gelenke","Sterile puncture of large joints"],"prefix":"10.1007","volume":"35","author":[{"given":"Viktor","family":"Labmayr","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz Josef","family":"Eckhart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Smolle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Klim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan Franz","family":"Fischerauer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerwin","family":"Bernhardt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franz Josef","family":"Seibert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,1,17]]},"reference":[{"key":"786_CR1","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.amjmed.2011.08.022","volume":"125","author":"I Ahmed","year":"2012","unstructured":"Ahmed\u00a0I, Gertner\u00a0E (2012) Safety of arthrocentesis and joint injection in patients receiving anticoagulation at therapeutic levels. 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