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Es handelte sich um 41\u00a0M\u00e4nner und 13\u00a0Frauen mit einem Durchschnittsalter von 65,1\u00a0Jahren, die im Zeitraum 2003\u20132016 nach kardiochirurgischem Eingriff eine TSWI entwickelten. Die Behandlungsstrategie setzte sich zusammen aus dem konsequenten D\u00e9bridement, einschlie\u00dflich der Entfernung des einliegenden Fremdmaterials, der Rekonstruktion nach Infektbeherrschung mit stabiler Reosteosynthese und ggf. situationsbedingter Lappenplastik f\u00fcr eine gut durchblutete Defektdeckung und zwingender Vermeidung von Totraum. Es wurden insgesamt 146\u00a0Operationen erforderlich (durchschnittlich 2,7\u00a0Operationen\/Patient, Bereich: eine bis 7\u00a0Operationen). In 24,1\u202f% der F\u00e4lle konnte ein einzeitiges Vorgehen durchgef\u00fchrt werden. Bei 41\u00a0Patienten wurde zur Wundkonditionierung die \u201enegative pressure wound therapy\u201c (NPWT) mit programmierten Schwammwechseln angewendet (im Mittel\u00a05\u00a0Wechsel, Standardabweichung [SD] \u00b1\u202f5,6 Wechsel \u00fcber 22\u00a0Tage, SD \u00b1\u202f23,9\u00a0Tage, Wechselintervall alle 3 bis 4\u00a0Tage in 40,7\u202f% der F\u00e4lle). Bei 33\u00a0Patienten wurde ein beidseitiger myokutaner Pectoralis-major-Lappen genutzt, bei 4\u00a0Patienten ein \u201eVertical-rectus-abdominis-myocutaneous\u201c(VRAM)-Lappen, bei\u00a07\u00a0Patienten beide. Am Sternum wurden 43\u00a0Osteosynthesen mit winkelstabilen Titanplattensystemen durchgef\u00fchrt. Sieben\u00a0Patienten verstarben unter intensivmedizinischer Behandlung (Gesamtmortalit\u00e4t 13\u202f%; <jats:italic>n<\/jats:italic>\u202f=\u20095 (9,3\u202f%) \u2264\u202f30\u00a0Tage) oder im weiteren Verlauf. Mit saniertem Infekt konnten 47\u00a0Patienten entlassen werden (87,1\u202f%). Bei 2\u00a0Patienten wurden die Implantate nach 2\u00a0Jahren wegen Auslockerung entfernt.<\/jats:p>","DOI":"10.1007\/s00113-023-01394-x","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T16:10:49Z","timestamp":1702397449000},"page":"211-220","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Behandlungsregime tiefer sternaler Wundinfektionen nach kardiochirurgischen Eingriffen im interdisziplin\u00e4ren Ansatz","Treatment regimen for deep sternal wound infections after cardiac surgical interventions in an interdisciplinary approach"],"prefix":"10.1007","volume":"127","author":[{"given":"D.","family":"Bieler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Franke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"V\u00f6llmecke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Hentsch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Markewitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Kollig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,12,12]]},"reference":[{"issue":"4","key":"1394_CR1","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1016\/j.ejcts.2009.09.023","volume":"37","author":"R Baillot","year":"2010","unstructured":"Baillot\u00a0R, Cloutier\u00a0D, Montalin\u00a0L et al (2010) Impact of deep sternal wound infection management with vacuum-assisted closure therapy followed by sternal osteosynthesis: a\u00a015-year review of 23,499 sternotomies. 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