European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Eur J Trauma Emerg Surg · Jun 2020
It is time for a change in the management of elderly severely injured patients! An analysis of 126,015 patients from the TraumaRegister DGU®.
The number of elderly patients among the severely injured has been increasing continuously. It has been suggested that an increased life expectancy and a higher level of activity and mobility in older ages could explain this observation. Elderly trauma patients have relevant higher mortality rates and poorer functional outcomes. The reasons remain unclear. The aim of this study was to look for differences in the management of severely injured elderly patients compared to younger age groups and to evaluate their potential impact on outcome. ⋯ Severely injured elderly patients are treated with a more "wait and see approach" resulting in higher mortality rates. We suggest that this population needs a more "aggressive management" to improve their outcome, if the wish to perform complete treatment including surgical procedures and intensive care medicine has not been excluded by the patients or their legal guardian.
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Eur J Trauma Emerg Surg · Jun 2020
Local fixation of antibiotics with fibrin spray on soft tissues: experimental study on the relevance of the application techniques.
In acute and chronic infections of soft tissue, a radical surgical debridement is necessary, and is regarded as the 'Gold Standard, as well as an immediately systemic antibiotic therapy. Additional treatment with local antibiotics and/or antibiotic-containing materials is commonly used in clinical settings, but the efficient concentration of the antibiotic is not well-known. ⋯ This easy and inexpensive method of application can be a promising factor for the clinical improvement of local antibiotic therapy.
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Eur J Trauma Emerg Surg · Jun 2020
Editorial CommentFocus on "The German TraumaRegister DGU® (TR-DGU)".
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For decades, clavicle fractures have been treated conservatively. In the last 20 years, however, non-union rates after conservative treatment appear higher than previously reported and more evidence regarding operative treatment has become available. This has led to a paradigm shift towards an increase in operative treatment. The aim of this review is to present the current concepts and available evidence regarding clavicle fracture treatment. ⋯ In general, non-displaced fractures are treated conservatively. Operative treatment has to be discussed with patients with displaced clavicle fractures, especially in the young and active patient.