title: [The interdisciplinary approach in reconstructive surgery of the extremities].
abstract: In cases of extended post-traumatic soft-tissue and bone loss as well as with mutilating infection or radical tumor resection, multidisciplinary options are required to salvage extremities and functional rehabilitation. A surgical team approach allows for reduction of amputation rates, wound healing complications, and secondary procedures in limb oncology and trauma. The goals and limitations of cooperative surgical concepts are described. In the future, continuing medical education will focus not only on indications and techniques but also on complication management, medicolegal problems, and economic deficits due to maladapted legal structures. Provided clear clinical pathways are introduced to guide indications, surgical procedures, and postoperative treatment, marked financial deficits may be avoided. While, in the past, responsibility for the patient and ethical considerations resulted in the development of voluntary interdisciplinary treatment programs, economic strategies and an increasing number of malpractice suits will inevitably produce new imperatives for interdisciplinary cooperation in the future.
authors.affiliation: Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, BG-Kliniken Bergmannsheil, Ruhr-Universität Bochum. hans-ulrich.steinau@bergmannsheil.de
authors.forename: H U
authors.initials: HU
authors.lastname: Steinau
authors.forename: B
authors.initials: B
authors.lastname: Clasbrummel
authors.forename: C
authors.initials: C
authors.lastname: Josten
authors.forename: H H
authors.initials: HH
authors.lastname: Homann
authors.forename: M
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: D
authors.initials: D
authors.lastname: Druecke
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000331:legislation & jurisprudence; D001859:Bone Neoplasms / Q000601:surgery*; D019091:Critical Pathways / Q000331:legislation & jurisprudence; D005260:Female; D050723:Fractures, Bone / Q000601:surgery*; D005858:Germany; D006801:Humans; D023821:Limb Salvage / Q000331:legislation & jurisprudence*; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D009104:Multiple Trauma / Q000601:surgery*; D010348:Patient Care Team / Q000331:legislation & jurisprudence; D019651:Plastic Surgery Procedures / Q000331:legislation & jurisprudence; D012017:Referral and Consultation / Q000331:legislation & jurisprudence; D012086:Reoperation / Q000331:legislation & jurisprudence; D017695:Soft Tissue Injuries / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000601:surgery*; D014946:Wound Infection / Q000601:surgery