Freitag, 20. Juli 2012

A hospital without hospital infection - Medical Well Clinic Dresden

 To mark the 10 year anniversary (2012) of Medical Well Clinic Dresden, we would like to reflect on an important fact:  In all this time, we haven’t had any post-operative surgical           site infections (SSI; occurring as a result of surgery)  on our premises .

The unsolved problem:

"Every year about 3 million patients get hospital infections in European hospitals. Of these, 225 000 patients catch a postoperative wound infection. 50,000 people die as a result." (Source: ‘Bacteria Beyond a Cure’, Süddeutsche Zeitung, 10 October 2008, p. 22)

Multi-drug resistant germs either disable patients for months or years, or even lead to death. Hospital-acquired infections developed into the most expensive and dangerous contagious disease in all times – what a topsy turvy world.

How could this have happened?

"Over the past two decades, (...) the increased and irrational use of antibiotics in the treatment of infectious diseases led to an alarming increase of multidrug-resistant problem organisms (Methicillin-resistant Staphylococcus Aureus, Vancomycin-resistant Enterococci and more). There is a direct correlation between the increased use of broad-spectrum antibiotics and the increase of multidrug-resistant pathogens." (Source: WIKIPEDIA # cite_note-5)

As early as the early sixties - with the development of new antibiotics - alerts were already raised, stating that those potent drugs which were so rich of side-effects required a highly critical approach. Even then, it was anticipated that an increasing use of those drugs would evolve in bacterial resistance. Those bacteria are flexible and in their incredible numbers they are surprisingly clever. They even know how to inform each other via plasmids. Together they form defensive strategies against toxins like antibiotics. They become resistant.

My personal approach to the critical use of antibiotics and surgical hygiene

Before the Internet, Professor Emmerich Lang from Vienna published a magazine for the critical handling of antibiotics. I regularly read this magazine and processed the information. Since 1971, and still a student, I critically contemplated pharmacotherapy, particularly antibiotic therapy, excerpting the incorruptible pharma newsletter "Arznei-Telegramm". In all hospitals of my residency, I became a member of the Drug Commission and have thus helped acquire critical usage of medication as well as their low-budget purchase.
Professor F. Daschner, University of Freiburg , Germany (emerit. 2006), influenced my knowledge and clinical behavior, too.
Professor H. Willenegger and especially his lecture "On the Comeback of Topical Antiseptics in Surgery" in 1990 made a great impact on me. From 1996 on I followed consequently his hints and had never to treat a SSI in over 7.500 operations in a serie.
Professor A. Kramer, University of Greifswald, Germany, is nowadays one of my mentors in terms of wound and hospital hygiene. His willingness to counsel and his free publication practice is exemplary.
This education I brought into my own practice for outpatient surgery in Görlitz, Saxony, 1993. There, we never had a postoperative infection.
In 2002, I was co-founder of Medical Well Clinic Dresden. We have increased our anti-infective measures still. 

Our anti-bacterial concept turned out to be resilient to error

Even imported multi-resistent germs, which might have originated in other hospitals or stay in old people´s house or nursing care of chronic wounds or have come from handling antibiotics-contaminated (chicken) meat 
(Source: ) 
never resulted in infections in our clinic. 

 A clinic without any post-operative infections for over 10 years, is truly remarkable worldwide and comprehensive only as the result of a successful concept. This cannot be a coincidence. This concept includes not only the critical usage of antibiotics but also additional elements. We have developed a method to treat our clothes, patient’s bedding, and the walls of our operating rooms with antibacterial capability. For humans this antibacterial treatment is completely safe. It attacks only typical components of bacteria and destroys them. No bacterium can survive in this antibacterial environment for longer than 20 minutes. In addition, the germs of swine flu, avian flu, HIV, hepatitis, most fungi and many more cannot exist.

What good is a clinic with state-of-the-art equipment,  strictest hygiene protocol, with the best doctors and nurses - if infections are a common hazard and determine the fate of the patients, even if the surgical work was conducted well?

About Medical Well Clinic Dresden

In the infection-free Medical Well Clinic Dresden, only internationally recognized scientific methods of aesthetic plastic surgery are used.
In some areas we are part of the medical avant-garde. Among those are:

1st An infection-free surgical performance (see above)

2nd The rejection of aesthetic and cosmetic surgery in apparently healthy people with poor body composition.

We urge the cooperation of our patients to create the condition for a low-risk surgery. Our slogan: "Challenge us - we'll challenge you."
In case of poor body composition we support these patients with extensive experience in medical nutrition counseling and optimize their desired food (calculated as a guide portion list). We cooperate with qualified coaches and academically trained sports instructors. Surgery will be performed only in case of successful weight reduction and/or achievement of defined objective criteria (e.g. phase angle of min. 5.2 ° in women and 5.4 ° in men).

3rd Accelerated, nearly scar less wound healing.

Since 1996, we use a special gel composition combined with sophisticated sewing techniques to achieve fast, nearly scar less wound healing. In case of scars, mostly originating from accidents or out-house surgeries, we use the Medical Well Needling Concept to help create new own skin at the site of ugly and hampering scars.

4th Breast enlargement with local anesthesia.

For the patient, this method of surgery is surprisingly comfortable. This is evident in short recovery times. About 10% of patients are back at work the next day - just one day after the operation (!); about 30% of patients return after 3 days and 95% of patients are back at work after 7 days.
Remember: rate of infection: 0%

5th The Lipoabdominoplasty modo SALDANHA (special version of tummy tuck combined with liposuction).

With this technique of abdominoplasty, it is possible to achieve an increasingly good and accelerated wound healing, even in insulin-dependent diabetics who smoke. (Such patients are excluded from the traditional tummy tuck.) Moreover, the method SALDANHA maintains the preservation of sensitivity of the abdominal skin. The “feeling” does not perish. In comparison:  in classic abdominoplasty it is very common to develop large insensible areas of the skin and an increased incidence of wound complications with wide scars and eventually wound water formation (seromas).
How is that possible?
In contrast to the classic tummy tuck, arteries, veins, nerves and lymphatic vessels are not severed during abdominoplasty modo SALDANH. In the area of removed derma flaps (skin fat flaps) remains an unaffected stem-cell-rich fatty tissue layer above the abdominal fascia. It acts as a fertile ground for nourishing and regenerating the superimposed layers of skin to be sutured. The complication rate tends towards zero.
Remember: rate of infection: 0%

In our field of work, we have the following objectives:

  • Breast augmentation with own fatty tissue improving the uptake of cells and tissues
  • 3-dimensional facelift with patient’s own fat as an alternative to the classical facelift - in selected cases
  • Full regeneration of affected skin: damage caused by age, previous unsuccessful therapy attempts  (laser, Thermage, peeling, dermabrasion) or UV-radiation, i.e. Rejuvenation
  • Prevention of scarring after surgery and burns / scalds
  • Scar treatment after accidents and burns, acne scars
  • New skin formation in patients with ugly, painful and movement debilitating (hampering) scars
  • Diminishing of disfiguring defects after accidents or surgery, relining decubitus-risk areas with own fatty tissue
  • Vitiligo
  • Treatment of painful osteoarthritis with Stromal Vascular Fraction mechanichally prepared from own fatty tissue (in the near future)

Conventional stem cell therapies disappointed because of lack of efficacy, high costs, possible cancer susceptibility after many cell passages. They cannot be used intraoperatively - just in time. The manufacturing processes have only little physiological similarity. In the elaborate manipulation effort, the cells are alienated from their natural environment and they no longer respond to signaling molecules or behave uncontrolled. The manipulated stem cells are often applied in quantities which are too large. They don’t understand start and stop signals for differentiation. The natural wound environment is overwhelmed.

However, these new principles we will be employing imitate nature: 

So a new physiological principle was discovered and made therapeutically useful for humans. Here the conditions of small - no scarring - wounds are transferred to large wounds and brought into effect in different organizations of cells.
The new cell biological principle is cost effective and available to the patient intra-operatively with his own natural stem cells (Stromal Vascular Fraction) at any time in the Medical Well Clinic Dresden. It is the "stem cell therapy for everyone". Thousands of cases are documented in scietific literature.

Dr. Michael Meinking
Chief physician of Dresden Medical Clinic Well

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