[The present state of vacuum sealing].
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 in the future will inevitably produce new imperatives for interdisciplinary cooperation.
Tautenhahn
J
J
Klinik für Allgemein-, Viszeral- und Gefässchirurgie, Medizinische Fakultät der Otto-von-Guericke-Universität Magdeburg. joerg.tautenhahn@medizin.uni-magdeburg.de
Bürger
T
T
Lippert
H
H
D005121:Extremities / Q000293:injuries* / Q000601:surgery*; D006097:Granulation Tissue / Q000503:physiopathology; D006801:Humans; D023821:Limb Salvage / Q000295:instrumentation*; D009779:Occlusive Dressings; D016032:Randomized Controlled Trials as Topic; D013530:Surgical Wound Infection / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques / Q000295:instrumentation*; D014619:Vacuum Curettage / Q000295:instrumentation*; D014945:Wound Healing / Q000502:physiology