Die Risikofaktoren der akuten Fasziendehiszenz und ihr auftretendes Erregerspektrum - ist das Erregerspektrum relevant?

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dc.contributor.advisor Schäffer, Michael (Prof. Dr.)
dc.contributor.author Kandemir, Fatma Gül
dc.date.accessioned 2023-12-07T13:47:43Z
dc.date.available 2023-12-07T13:47:43Z
dc.date.issued 2023-12-07
dc.identifier.uri http://hdl.handle.net/10900/148479
dc.identifier.uri http://nbn-resolving.de/urn:nbn:de:bsz:21-dspace-1484795 de_DE
dc.identifier.uri http://dx.doi.org/10.15496/publikation-89819
dc.description.abstract Introduction: Acute fascia dehiscence (FD) is a threatening complication occurring in 0.4-3.5% of cases after abdominal surgery. Prolonged hospital stay, increased mortality and increased rate of incisional hernias could be following consequences. Several risk factors are controversially discussed. Even though surgical infection is a known, indisputable risk factor, it is still not proven if a special spectrum of pathogens is responsible. In this study, we investigated if a specific spectrum of microbial pathogens is associated with FD. Methods: We performed a retrospective matched pair analysis of 53 consecutive patients with an FD after abdominal surgery in 2010-2016. Matching criteria were gender, age, primary procedure and surgeon. The primary endpoint was the frequency of pathogens detected intraoperatively, the secondary endpoint was the occurrence of risk factors in patients with (FD) and without (nFD) FD. Results: Intraabdominal pathogens were detected more often in the FD group (p = 0.039), with a higher number of Gram-positive pathogens. Enterococci were the most common pathogen (p = 0.002), not covered in 73% (FD group) compared to 22% (nFD group) by the given antibiotic therapy. Multivariable analysis showed detection of Gram-positive pathogens, detection of enterococci in primary laparotomy beside chronic lung disease, surgical site infections and continuous steroid therapy as independent risk factors. Conclusion: Risk factors are factors that reduce wound healing or increase intra-abdominal pressure. Furthermore detection of Gram-positive pathogens especially enterococci was detected as an independent risk factor and its empirical coverage could be advantageous for high-risk patients. en
dc.language.iso de de_DE
dc.publisher Universität Tübingen de_DE
dc.rights ubt-podno de_DE
dc.rights.uri http://tobias-lib.uni-tuebingen.de/doku/lic_ohne_pod.php?la=de de_DE
dc.rights.uri http://tobias-lib.uni-tuebingen.de/doku/lic_ohne_pod.php?la=en en
dc.subject.ddc 610 de_DE
dc.subject.other Akute Fasziendehiszenz, Platzbauch, Enterokokken-Infektion de_DE
dc.subject.other burst abdomen en
dc.title Die Risikofaktoren der akuten Fasziendehiszenz und ihr auftretendes Erregerspektrum - ist das Erregerspektrum relevant? de_DE
dc.type PhDThesis de_DE
dcterms.dateAccepted 2023-03-03
utue.publikation.fachbereich Medizin de_DE
utue.publikation.fakultaet 4 Medizinische Fakultät de_DE
utue.publikation.noppn yes de_DE

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