Der Unfallchirurg
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There is clinical evidence, that a standardized management of trauma patients in the emergency room improves outcome. ⋯ ATLS teaches a standardized and established approach to the trauma patient in the emergency room. It has been transferred to 46 countries and the content is reviewed regularly to consider new scientific evidence. Germany has the chance to participate in this international standard of care and to introduce own experiences into the review process.
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Comparative Study
[External quality management in the clinical treatment of severely injured patients].
The Trauma Registry of the German Society of Trauma Surgery represents a database for interhospital quality management in the field of treating severely injured patients. The presented study analyzes the Trauma Registry's impact on treatment quality in the participating hospitals. Since 1998 annual feedback on treatment quality was given to the hospitals of the Trauma Registry. ⋯ At the same time a significant reduction of days of ventilation therapy from 11+/-14 to 9+/-14 was detected. The continuous feedback of the quality of the treatment process led to optimization measures in many hospitals taking part in the Trauma Registry. Furthermore, significant timesavings in the early treatment process could be shown.
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Opinions vary with regard to the equipment and structural furnishings required for adequate management of the trauma patient in the dedicated shock suite. In order to assess the current situation in Germany, we conducted a survey of the 76 centers participating in the Polytrauma Registry of the DGU. Fifty-one questionnaires were returned by centers representing all levels of care. ⋯ Fourteen centers desire changes but do not currently have the required money. Information provided by Philips and Siemens suggests that the cost of furnishing a new shock suite ranges between 1.4 and 1.7 million euros. Responses to our survey show that a large gap remains between wishes and reality in the technical infrastructure in many shock suites in Germany.
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From the perspective of trauma and orthopedic surgery interdisciplinary reconstructive surgery of the extremities encompasses different indications ranging from IIIB/Copen fractures with major segmental loss of bone and soft tissue, to arterial vessel in-jury necessitating vascular repair and to biological, plastic reconstructions following resections of musculoskeletal tumors. The interdisciplinary treatment concept including trauma-orthopedic surgery combined with vascular, plastic and neuro- as well as microsurgery has significantly decreased amputation rates and functional deficits thereby improving quality of life and long-term oncological outcome The multisdisciplinary management of both complex trauma and malignant bone/ soft tissue sarcoma of the extremity is an integral task of the surgical trauma or tumor center. Close interdisciplinary communication and expierence are the precondition for performance of a priority-adapted therapeutic strategy, low complication rates and improvement of overall prognosis.