Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[General automated documentation and performance data on the surgical intensive care unit--the theoretical concept of the Regensburg Surgical University Clinic].
Documentation is becoming an ever more time-consuming task due to the need to document increasing ICU productivity, quality management and cost-assessment data. Automatic charting of on-line monitoring data, therapeutic-device data, clinical laboratory data, microbiological data, radiological data and other data reduces documentation time significantly. ⋯ Not only the physician, but also nurses and physiotherapists are able to benefit from these advantages. Our concept, SURGIC (Department of Surgery, University Regensburg, Germany, Intensive Care), stands for: widely automated documentation, work orientation, including physicians, nurses' and physiotherapists' tasks, minimal dataset for simple use and perfect overview, costs assessments, scientific dataset, SICU PDMS as a part of the clinical information system, and professional support by a software-house is necessary.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Diagnostic problems in acute appendicitis and indications for laparoscopic appendectomy].
A retrospective study analyzing the outcome of 400 appendectomies for acute appendicitis in two different hospitals revealed a negative appendectomy rate of over 25%. As a consequence we altered the operative strategy by employing diagnostic laparoscopy in combination with laparoscopic appendectomy in all uncertain cases while still carrying out a conventional appendectomy when there was diagnostic certainty. Preliminary results show that laparoscopic appendectomy is a safe procedure and that the new concept reduces the negative appendectomy rate.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Surgery in the elderly--extent and status in surgery].
The results of selected elective and emergency operations of patients treated in the surgical department of Bonn University in 1994 and 1995 are presented and compared to the ASA-score. It was possible to show that old age itself is not a contraindication for major surgical interventions but that lethality mainly depends on concurrent diseases, i.e. the biological age. ⋯ An age-specific factor which cannot be measured is the psychosocial age, the mental health. Mental health has an important influence on surgery in the aged patient.
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The main problem facing the German transplantation program is the failure to obtain a continuous increase in organ procurement. To overcome the resulting lack of transplantable organs it is absolutely necessary to have a final parliamentary decision on a transplantation law in Germany. Organisational structures for transplantation, organ allocation and organ donation can be immediately implemented once legislation exist.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1992
Review[Thoracic injuries--when is use of the heart-lung machine necessary?].
Most patients with severe blunt or penetrating thoracic injuries die early after the accident (approximately 50%). The majority of those who reach an emergency department (approximately 80-85%) can therefore be treated initially with intensive observation (following drainage and/or intubation). If clinical deterioration due to continuous bleeding or progressive hemodynamic and respiratory problems occurs, however, urgent surgical intervention is indicated. Transfer of those critical patients to specialized hospitals often becomes dangerous because of time loss, and it is unnecessary as major equipment (e.g., extracorporeal circulation) is demanded only in the minority of operations.