Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Comparative Study
[Surgical research in Germany. Organization, quality and international competitiveness].
Surgical research in Germany is performed within surgical clinics by individual working groups or in surgical research divisions. Additionally, a few independent institutes and departments of surgical research have been established at medical faculties. The number of these institutions, however, is too small. ⋯ This may be due to the fact that 85% of these top publications are published in non-surgical journals. The aim for the future must therefore be to increase the impact factor and, thus, the attractiveness of surgical journals. This may be achieved by publishing the highest quality results from experimental surgical research not in non-surgical but in surgical journals.
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The dominant role for the emergence and establishment of intensive care medicine can be attributed to surgery. The first critical care units were developed in surgical university hospitals. Numerous scientific findings and interventional procedures have been contributed to intensive care medicine by surgeons and surgical disease symptoms shaped the character of the intensive care units. ⋯ Through the formation of large interdisciplinary intensive care units, surgery continues to be threatened with losing its influence even further. Now and in the future, the role of surgery has to be the maintenance and enhancement of surgical specialized intensive care medicine. Surgery has to make surgical intensive care medicine interesting and attractive for physicians again.
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Partnership on equal terms between the nursing and medical profession at the Surgical Department of the University Hospital Heidelberg has become evident as shown exemplarily in central patient management, wound management and acute pain service. By using the skills of both professions, aims to improve patient care and operational procedures have been agreed. ⋯ Physicians have experienced a clear relief in pressure and quality has simultaneously been improved. This partnership leads to an atmosphere of respect and recognition.
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Surgery and anesthesiology have always been closely connected. Within the increasing complexity of therapies and technical capabilities both subjects overlap in certain areas. This article deals with the question whether anesthesiology is acting as a partner or competitor in the cooperation with the various operative specialties. In several studies it has been shown that the outcome of surgical patients can be improved by communication and interaction with anesthesiology and that forming multidisciplinary teams will be highly beneficial for patients in intensive care units.
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The benefits of interdisciplinary approaches in patient care, research and education are quite obvious and set the trend for more interdisciplinary structures. In order to achieve sustained success, however, there are numerous risks of interdisciplinary collaboration that have to be considered. Interdisciplinarity leads to an increasing degree of specialization and consequently to a greater experience of specialists in highly specific procedures. ⋯ Hence, the education of young physicians, students and researchers has to be adapted to this reality. It remains unanswered if these changes contribute to the decline in the number of applicants in surgery. In conclusion, the risks of the contradictory contexts of interdisciplinarity can be counteracted with simple principles of fair and cooperative partnership.