Langenbeck's archives of surgery
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Langenbecks Arch Surg · Mar 2021
Multicenter Study Observational StudySuspected appendicitis and COVID-19, a change in investigation and management-a multicentre cohort study.
The COVID-19 pandemic has reformed global healthcare delivery. On 25 March 2020, Intercollegiate guidelines were published in the UK to promote safe surgical provision during the COVID-19 outbreak advocating non-operative management or avoidance of laparoscopy when surgery is essential. The effects of this on the investigation and management of appendicitis remain unknown. ⋯ Introduction of the guidelines was associated with changes in practice. Despite these changes, short-term complications did not increase and LOS decreased. Questions remain on the longer-term complication rates in non-operatively managed patients.
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Langenbecks Arch Surg · Mar 2021
Multicenter StudyAppendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany.
The COVID-19 pandemic has transformed medical care worldwide. General surgery has been affected in elective procedures, yet the implications for emergency surgery are unclear. The current study analyzes the effect of the COVID-19 lockdown in spring 2020 on appendicitis treatment in Germany. ⋯ The COVID-19 lockdown had significant effects on abdominal emergency surgery in Germany. These seem to result from a stricter selection and a longer waiting time between the onset of symptoms and medical consultation for risk patients. However, the standard of emergency surgical care in Germany was maintained.
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Langenbecks Arch Surg · Apr 2015
Multicenter StudyPrehospital fluid management of abdominal organ trauma patients--a matched pair analysis.
Severe bleeding after trauma frequently leads to a poor outcome. Prehospital fluid replacement therapy is considered an important primary treatment option. We conducted a retrospective matched pair analysis to assess the influence of prehospital fluid replacement volume on the clinical course of patients with solid abdominal organ trauma. ⋯ Excessive prehospital fluid replacement is able to lead in an increased mortality rate in patients with solid abdominal organ injury. Our results support the concept of restrained fluid replacement in the preclinical treatment of severe trauma patients.
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Langenbecks Arch Surg · Oct 2014
Randomized Controlled Trial Multicenter StudyHemostatic efficacy of latest-generation fibrin sealant after hepatic resection: a randomized controlled clinical study.
This randomized, controlled, single-blinded multicenter study evaluated the efficacy of latest-generation fibrin sealant containing synthetic aprotinin as fibrinolysis inhibitor as supportive treatment for hemostasis after elective partial hepatectomy. ⋯ Fibrin sealant was shown to be safe and superior to manual compression in the control of parenchymal bleeding after hepatic resection. The use of synthetic aprotinin as fibrinolysis inhibitor further improves the safety margin of fibrin sealant by eliminating the risk of transmission of bovine spongiform encephalopathy and other bovine pathogens.
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Langenbecks Arch Surg · Feb 2013
Multicenter StudySurgeons' work ability and performance in surgical care: relations between organisational predictors, work engagement and work ability.
The aim of this study was to examine relations and influences between work-related factors, personal resources, work engagement and work ability of surgeons working in German hospitals. ⋯ The study results reflect the positive effect of supportive working conditions and work engagement on the preservation of work ability, indicating their importance in promoting surgeons' work ability. Due to the elderly population and the continuing development of health care in Germany, the demand for surgeons increases. These circumstances give reasons for a strong need to preserve and restore surgeons' work ability. New strategies for training and improving the capacity and performance of surgeons are necessary.