Gewebemanagement

Gewebemanagement, or tissue management, is the planning, protection, and optimization of biological tissue during medical care to preserve function and promote healing. It spans surgical technique, wound care, tissue preservation, and regenerative medicine, and is applied in acute care, reconstructive surgery, dentistry, transplant contexts, and research.

Key aspects include assessing tissue viability, minimizing collateral damage, preserving blood supply, and handling tissues atraumatically. Decisions about when to harvest, graft, or replace tissue, and selecting grafts, flaps, synthetic biomaterials, or scaffolds, are central elements. Monitoring tools such as perfusion assessment and imaging support timely interventions.

Methods encompass surgical techniques that minimize tissue loss, debridement strategies, wound dressings, negative-pressure therapy, and strategies to promote revascularization. In regenerative contexts, tissue engineering approaches employ scaffolds, cells, and growth factors. Material science and sterilization practices ensuring asepsis are integral, as are data-driven planning and simulation.

Challenges in gewebemanagement include patient-to-patient variability, infection risk, regulatory and ethical considerations, and cost and access disparities. Effective practice requires multidisciplinary collaboration among surgeons, nurses, wound-care specialists, and bioengineers, as well as ongoing evaluation of outcomes related to function, appearance, and quality of life.