Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Comparative Study
[Organization of pain therapy in surgery--comparison of acute pain service and alternative concepts].
An acute pain service done by surgeons is one possibility for organizing pain therapy in surgical wards. To do this successfully, some preconditions must be kept in mind, such as 24-h presence, an integrated system of documentation, and teamwork between medical and nursing staff. Comparison of differently structured pain therapy in three different hospitals (with and without acute pain service) showed high levels of patient satisfaction with the pain therapies in all three hospitals. One of the preconditions for effective pain therapy in surgery is to formulate a concept which takes into account the specific situation of each hospital.
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Microsurgical reconstructions are considered an integral art of modern reconstructive concepts, especially in the fields of trauma, tumor reconstruction, and correction of congenital deformities. Patient expectations regarding function and aesthetics of plastic surgical reconstructions are satisfied with permanently improved flap designs that also lead to a significant reduction in donor site morbidity. Together with steadily decreasing complication rates, these options have made microsurgical reconstructions a prime choice in plastic surgery, in contrast to the past, where they were considered the "last line of defense."