Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Comparative Study
[The SOFA score in evaluating septic illnesses. Correlations with the MOD and APACHE II score].
The SOFA score, a new system for patients with sepsis-related diseases, was introduced in 1994 by the "Working Group on Sepsis-Related Problems of the European Society of Intensive Care Medicine." The purpose of this study was to compare the new SOFA score with the APACHE II and MOD scores. The data on 874 patients from a surgical intensive care unit in an university hospital were analyzed using commercially available software (SPSS for Windows, Version 7.5.2 and MS Excel '97). ⋯ The ROC analyses of the APACHE II, the MOD and the SOFA scores were comparable (area under the curve: APACHE II 0.73, MOD 0.77, SOFA 0.71). In conclusion, the SOFA score is reliable and might be useful in the daily routine of an intensive care unit.
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Interfragmentary movement and size of the fracture gap influence fracture healing. Limited movements promote callus formation and may result in increased mechanical stability. Although larger movements still promote callus formation, the bony consolidation of the fracture is hampered. ⋯ Therefore, having in mind a minimally invasive surgical approach, one should strive for good reduction of the fracture ends and flexible yet stable osteosynthesis. Dynamization of the fracture by enabling axial movement will close the fracture gap, stimulate tissue differentiation and possibly accelerate the healing process. External mechanical stimulation, however, has not been shown to effectively enhance the healing process under flexible fixation or in load-bearing patients.
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Penetrating neck injuries are potentially life-threatening injuries. Management is controversial despite decades of discussion in the literature. An algorithm for diagnosis and therapy is needed because of the potential risk of mortality. ⋯ Injuries were caused in seven cases by gunshots, in eight cases by broken glass, in one case by an iron rod, in one case by a spear, in one case by a branch and in 13 cases the penetrating injuries were stab wounds caused by knives. Complications like pseudoaneurysms and fistulas were not seen. No patient came to death.