Septische postoperative Komplikationen

Surgical debridement to optimise wound conditions and healing

“…Non‐vital skin initially becomes white/pale (ischaemic), then turns dark purple and finally black . Final necrosis is easy to recognise and can be excised with a scalpel.…”

“…Borderline poorly perfused to non‐vital, necrotic skin is sometimes difficult to differentiate. In this situation, excision should be carried out in a stepwise fashion until there is bleeding from the small vessels, thereby indicating vital and perfused tissue . The skin defect may be covered by a mesh graft.…”

“…As fat tissue necroses, its structure alters, becoming a liquid, deliquescent substance, which can be easily removed by a curette . In early fatty necrosis, when the tissue is still firm, it should be removed with a scalpel until bleeding from small vessels appears.…”

“…Necrotic cortical bone is white and looks like it is painted. It can appear like ivory or porcelain/china . Normal cortical bone has small spots from small blood vessels, which gives it a ‘dotted’ appearance.…”

“…Necrotic cancellous bone becomes soft, has granulation tissue between the trabeculae and can be removed with a curette. Distinguishing between necrotic, infected bone and vital, cancellous bone is often difficult.…”