Wound complications following kidney and liver transplantation

Publikation: Beitrag in FachzeitschriftÜbersichtsartikel (Review)BeigetragenBegutachtung

Beitragende

  • Arianeb Mehrabi - , Universität Heidelberg (Autor:in)
  • H. Fonouni - , Universität Heidelberg (Autor:in)
  • M. Wente - , Universität Heidelberg (Autor:in)
  • M. Sadeghi - , Universität Heidelberg (Autor:in)
  • C. Eisenbach - , Universität Heidelberg (Autor:in)
  • J. Encke - , Universität Heidelberg (Autor:in)
  • B. M. Schmied - , Universität Heidelberg (Autor:in)
  • M. Libicher - , Universität Heidelberg (Autor:in)
  • M. Zeier - , Universität Heidelberg (Autor:in)
  • J. Weitz - , Universität Heidelberg (Autor:in)
  • M. W. Büchler - , Universität Heidelberg (Autor:in)
  • J. Schmidt - , Universität Heidelberg (Autor:in)

Abstract

Advances in surgical techniques and immunosuppression (IS) have led to an appreciable reduction in postoperative complications following transplantation. However, wound complications as probably the most common type of post-transplantation surgical complication can still limit these improved outcomes and result in prolonged hospitalization, hospital readmission, and reoperation, consequently increasing overall transplant cost. Our aim was to review the literature to delineate the evidence-based risk factors for wound complications following kidney and liver transplantation (KTx, LTx), and to present the preventive and therapeutic modalities for this bothersome morbidity. Generally, wound complications are categorized as superficial and deep wound dehiscences, perigraft fluid collections and seroma, superficial and deep wound infections, cellulitis, lymphocele and wound drainage. The results of several studies showed that the most important risk factors for wound complications are IS and obesity. Additionally, there are surgical and/ or technical factors, including type of incision, reoperation, and surgeon's expertise, as well as comorbidities such as advanced age, diabetes mellitus, malnutrition, and uremia. Preventive management of wound complications necessitates defining their etiological factors so that their detrimental effects on healing processes can be addressed and reduced. IS modalities and agents, especially sirolimus (SRL), and steroids (ST) should be adjusted according to the patient's co-existing risk factors. SRL should be administered three months after transplantation and ST should be tapered as soon as possible. A body mass index (BMI) lower than 30 kg/m 2 is advisable for inclusion in a transplantation program, but higher BMIs do not exclude recipients. Surgical risk factors can be prevented by applying precise surgical techniques. Therapeutic modalities must focus on the most efficient and cost-effective medications and/or interventions to facilitate and improve wound healing.

Details

OriginalspracheEnglisch
Seiten (von - bis)97-110
Seitenumfang14
FachzeitschriftClinical Transplantation
Jahrgang20
AusgabenummerSUPPL. 17
PublikationsstatusVeröffentlicht - Dez. 2006
Peer-Review-StatusJa
Extern publiziertJa

Externe IDs

PubMed 17100709

Schlagworte

ASJC Scopus Sachgebiete

Schlagwörter

  • Kidney transplantation, Liver transplantation, Transplantation, Wound complications