Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
Comparative Study["Score systems as a measure for quality assurance in polytrauma?"].
Score systems in trauma try to aggregate the severity of injury in a single number of formula. They give a common basis to standardize logistics and outcome in trauma management. This holds true only if the score is valid, reliable, and based on a meticulous documentation of data. As errors cannot be excluded, individual decisions in trauma management can never rely on scores alone.
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Necrotizing fasciitis has changed considerably over time. The disease used to be due to group A streptococci and affected otherwise quite healthy or traumatized subjects. Today we see multibacterial infections in polymorbid or immunocompromised patients. ⋯ Sometimes frozen-section biopsy proves helpful. Septic immune response and organ failure develop rapidly in these patients. After vigorous staged necrosectomy, extensive plastic reconstruction is mostly required.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Blunt thoracic trauma--therapeutic relevance of results of roentgen image, ultrasound and computerized tomography].
In 60 patients with severe thoracic trauma the diagnostic procedures--X-ray of the chest, sonography and thoracic computed tomography (CT)--were reviewed for their incidence of finding all injuries. X-ray of the chest often failed to detect lung contusion and injuries in the mediastinal space. Four of five ruptures of the diaphragm were incidental findings on the occasion of laparotomy because of intraabdominal bleeding.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Education, postgraduate and continuing education in surgery--data for quality control].
Despite intensive educational training during medical school, there is hardly any occupational group like physicians that tries to keep further education on a very high level. However, under the aspect of quality control, there is a need for different certificates. ⋯ The analysis of the committee of education of the Ruhr University Bochum must be considered as ideal; the results have to be transferred. Objective medical care results and patient satisfaction are influenced by many factors.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Unnecessary admission from the surgical social medicine viewpoint].
Wrongfully inpatient admission means unnecessary treatment of patients with the means of a hospital. In a study of the Medical Service (MDK) in the German state of Hessen 58% of 954 inpatients were considered wrongfully admitted. 199 patients were treated surgically, the wrongful admission rate of 63% is caused by an unnecessary duration of pre- and postoperative treatment time as well as by organizational deficits.