• Der Unfallchirurg · Sep 2017

    Review

    [Polytrauma and concomitant traumatic brain injury : The role of the trauma surgeon].

    • A Antoni, T Heinz, and J Leitgeb.
    • Universitätsklinik für Unfallchirurgie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.
    • Unfallchirurg. 2017 Sep 1; 120 (9): 722-727.

    BackgroundConcomitant traumatic brain injury (TBI) increases mortality and reduces quality of life of polytrauma patients. These facts demand effective treatment strategies while the growing specialization of medicine is questioning the role of the trauma surgeon in the management of these patients.ObjectivesWhich factors influence outcome of polytrauma with concomitant TBI? Who should be responsible for the management of these patients and what is the limit of management?Materials And MethodsA literature search using Medline via PubMed was performed with Medical Subject Headings and text word search.ResultsThe crucial factors for outcome are absence of hypotension, adherence to pre- and in-hospital standards like fast transportation to appropriate centers, priority-based diagnostic and therapeutic strategies and strict adherence to principles of damage control surgery. Patients with polytrauma and TBI are treated by different specialties around the world based on the trauma system, geographic circumstances and resources. Investigations of operative and conservative management by different medical specialties showed comparable outcomes.ConclusionsIn an age of standardization and a high degree of specialization in the field of medicine, the trauma surgeon still seems to be able to ensure an optimal treatment of polytrauma and concomitant TBI by focusing on priority-based diagnostic and therapeutic strategies and adhering to principles of damage control surgery.

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