Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Visceral outpatient operations are well established in Dresden. Since 1978, 13,948 cases have been operated on in general surgery. Most patients (57.8%) had local anesthesia; only 9.2% needed general anesthesia. ⋯ With careful selection of patients and the right indication, complications are rare in outpatient surgery. In only 0.7% of all cases did wound infections occur postoperatively. None of the patients died.
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The culture and transplantation of keratinocytes are considered an important progress in the treatment of severe burns. The keratinocyte grafts take best (50 to 90%) on remaining dermal structures after deep dermal (II b) burns. ⋯ As vital wound cover they allow for a rapid and near scarless reepithelialization. For deep (III) burns we use composite grafts of cultured auto-keratinocytes on allo-dermis with increasing success (up to 75% take rate) without rejection.
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Establishing day care and short stay surgery in trauma departments requires a careful estimation of the perioperative risks. Having the therapy be successful for each patient admitted to day care surgery should have precedence over any economic limitations. In day care surgery a trauma surgeon has to make sure that appropriate postoperative supervision is available for each patient discharged from the hospital. The surgeon is responsible for qualified care on an outpatient basis.