Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Does rationing of intensive care beds lead to premature ward return with preventable complications?].
Readmission to the surgical intensive care unit was necessary in 105 of 2269 patients (4.6%) who were discharged between 1991 and 1995. Mortality was 20% Cardiopulmonary reasons during the first 72 h after initial discharge were rare [33 patients (1.4%)].
-
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.
-
Langenbecks Arch Chir Suppl Kongressbd · Jan 1997
[Changes in postgraduate education (health policy prerequisites, work schedule regulation)].
Postgraduate training is an integral part of becoming a doctor. Postgraduate training in Germany is learning by doing, while working as a doctor. ⋯ There is a clear disproportion between the demand for postgraduate-training posts and the corresponding supply. By flexibilisation of the regulations for postgraduate training and by complementing methods for training and learning, the downward movement of the capacities for postgraduate training will be taken care of.
-
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.
-
Guidelines for the treatment of fractures in children include social and therapeutic parameters, such as adequate hospitalization for children, a definitive therapy with a low degree of invasiveness, and a high degree of freedom of mobility. The selection of a method is linked to the patient's requests. ⋯ Therapeutic strategies should be compared not only with regard to results, but also with regard to effectivity and efficiency. There are no strict guidelines in therapeutic procedures whatsoever.