[Management of polytrauma].
The first hours after trauma are decisive. Therefore the treatment chosen demands very strict planning according to concepts of modern quality management. This begins with the fastest possible and most efficient delivery of injured patients to the applicable clinic. Such institutions are permanently ready and have at their service all the necessary diagnostic techniques and surgical and intensive care methods. Effective shock treatment entails standardized procedures accompanied by up-to-date diagnostic and therapeutic measures. After admittance and therapy of life-threatening injuries (immediate measures, damage control surgery), early-stage surgery will follow (soft tissue injuries and fractures). Strategy of damage control orthopedics is growing in acceptance because of the potential danger to life functions due to pro- and anti-inflammatory response induced additional trauma caused by following surgery. Fractures initially stabilized by external fixation can consecutively be treated safely by secondary conversion osteosynthesis. A considerable improvement in quality can be attained through therapeutic procedures approved by all concomitant disciplines and standardized systems with internal and external control methods.
Nast-Kolb
D
D
Klinik für Unfallchirurgie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Deutschland.
Ruchholtz
S
S
Waydhas
C
C
Taeger
G
G
D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D016267:External Fixators; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011379:Prognosis; D012086:Reoperation; D017695:Soft Tissue Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D017749:Total Quality Management; D015599:Trauma Severity Indices