Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Changes in the spectrum of the health provision contract and their effects on education, graduate education, research, quality of treatment and continuing development of surgery].
The legal "contract for patient care" issued by the Federal Government for all hospitals interferes with graduate medical education (approbation order), postgraduate surgical training, the KMK paper for new structures and financing of university medicine, health politics of the Physicians Parliament and the Legal Health System, guidelines for surgical practice, internal and external quality measurement, and, last but not least, with clinical research in surgery. The different effects are outlined in detail.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Treatment of postoperative lung failure with prone positioning].
Of forty-three consecutive patients with severe adult respiratory distress syndrome (ARDS) treated in the prone position pulmonary function improved significantly in 39 patients during the first 12 h in prone position. Changes were most pronounced in patients with high QS/QT, as well as in patients in the early stages of ARDS. Twenty-eight patients could be weaned from the ventilator, and 22 patients were able to leave the hospital. These results suggest that prone position has an important role in the overall therapeutic approach to ARDS and should be used as early as possible.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Skin cultivation in treatment of severely burned patients].
In severe burns a total body surface area (TBSA) of more than 60% restricts possible donor areas for autologous STS coverage. Additional wound surfaces may further harm the patient. ⋯ Long culture times from 14 (KFGS) up to 28 days (CEA), infection of the culture and the woundbed, mechanical instability in the first period after grafting, restoring the dermal equivalent in full thickness burns and high costs are the problems of this new means of burn wound covering. Technical details of cultivation and coverage procedures using CEA and KFGS are discussed.