Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
-
Abdominal surgery is regularly followed by immune dysfunction that can last for several days. In case of septic complications during this period, there is imminent danger of mortality due to reduced immune function. This fact leads to classification of sepsis in regard to its genesis: spontaneously acquired sepsis type A is distinguishable from sepsis type B, which is acquired postoperatively. ⋯ A direct correlation exists between magnitude of immune dysfunction and complexity of the previous surgical trauma. For the first time it is now possible to study this phenomenon of postoperative immune dysfunction by use of an adequate animal model. Intestinal manipulation in mice fulfils the necessary criteria to serve as a model of surgically induced immune dysfunction.
-
For 1 year now, German surgical multicentric randomised controlled trials (MRCT) in Germany may be included under the heading "Clinical Trials" in our monthly updated trial list. ⋯ The new regular heading gives important details about ongoing surgical trials in Germany. The steady growth of trials and recruited patients demonstrates the practicability of randomized controlled trials in surgery.
-
Nosocomial infections are still an important issue in surgical wards. About one patient in 15 is affected, most of them from surgical site or urinary tract infections, but pneumonia cases can also be observed frequently. ⋯ About one third of nosocomial infections can be regarded as avoidable. Routine surveillance of nosocomial infections and multiresistant pathogens, feedback of data to all personnel involved in patient care, and routine educational activities in this field are the crucial elements for achieving high compliance with the most important infection control measures.
-
Review Comparative Study
[Patterns of injury in a combat environment. 2007 update].
Epidemiological analysis of injury patterns and mechanisms help in identifying the expertise that military surgeons need in a combat setting and also in adjusting training requirements accordingly. This paper attempts to assess the surgical specialties and skills of particular importance in the management of casualties in crisis areas. ⋯ Military surgeons must have excellent skills in the fields of thoracic, visceral, and vascular surgery as well as practical skills in neurosurgery and oral and maxillofacial surgery. It also is of vital importance to ensure the availability of sufficient medical evacuation capabilities. Furthermore, there is a need for a standardized registration system for all injuries similar to the German Trauma Registry.