Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Outcome of primary surgical management of liver trauma].
We evaluated retrospectively 43 patients with liver trauma undergoing laparotomy between 1/89 and 12/95. Blunt trauma (27 patients) and penetrating trauma (16 patients) to the liver had a mortality of 37% and 0%, respectively. The overall mortality was 23.3% and was significantly related to concomitant injuries (p = 0.002), whereas age, severity of the liver trauma as well as the surgical treatment had no significant influence on the outcome.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Comparative Study["Score systems as a measure for quality assurance in polytrauma?"].
Score systems in trauma try to aggregate the severity of injury in a single number of formula. They give a common basis to standardize logistics and outcome in trauma management. This holds true only if the score is valid, reliable, and based on a meticulous documentation of data. As errors cannot be excluded, individual decisions in trauma management can never rely on scores alone.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Guidelines in trauma surgery--geriatric traumatology].
The treatment of injuries in elderly patients requires thorough planning. Preexisting diseases and the current status determine the priorities and methods of treatment. ⋯ Fracture treatment aims at fast, careful and simple fixation, which is nevertheless stable and sufficient. Modern methods and implants allow acceptable results to be achieved, even under the limitations of modern health care systems.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Shock room management in severe craniocerebral trauma].
Early clinical management of severe head injury should take place in an emergency resuscitation room and be conducted according to the guidelines of the treatment of severely injured patients with attention given to time. The first phase (with a maximum duration of 30 min) comprises physical examination, stabilisation of vital functions and basic technical diagnostics. With pulmonary and circulatory functions stabilized, the second phase begins with a craniol computed tomography examination followed by adequate therapeutic measures, including, if necessary, the CT-controlled implantation of an intracranial pressure catheter.
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Necrotizing fasciitis has changed considerably over time. The disease used to be due to group A streptococci and affected otherwise quite healthy or traumatized subjects. Today we see multibacterial infections in polymorbid or immunocompromised patients. ⋯ Sometimes frozen-section biopsy proves helpful. Septic immune response and organ failure develop rapidly in these patients. After vigorous staged necrosectomy, extensive plastic reconstruction is mostly required.