Langenbecks Archiv für Chirurgie. Supplement. Kongressband. Deutsche Gesellschaft für Chirurgie. Kongress
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
Comparative Study Clinical Trial Controlled Clinical Trial[Surgical prevention of post-traumatic infection by immediate necrectomy of burn wounds].
Sepsis is the commonest cause of death following burn injuries. The main source of the bacteria which cause the onset of sepsis is the burn wound itself. We evaluated the question of whether immediate necrectomy versus early necrectomy leads to a decrease in septic complications, as well as posttraumatic lethality. ⋯ Following immediate necrectomy (group 1), septic complications developed in 12.1%, as compared to 33.3% in group 2 (p < 0.01). Lathality was significantly reduced in group 1 with 9.1% compared to 21.2% in group 2 (p < 0.01). In this study it was demonstrated that immediate necrectomy versus early necrectomy in young patients leads to a significant decrease of septic complications and lethality following burn injury.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
Comparative Study[Extra-articular proximal femur fracture in the elderly--dynamic hip screw or intramedullary hip screw for fracture management?].
Over a 6-year period we treated 119 pertrochanteric fractures using dynamic hip screws (DHS). During the following 3 years we stabilized 112 per-, sub- and intertrochanteric, as well as "trochanter-associated" fractures by means of intramedullary hip screws (IMHS) or gamma nails (GN). ⋯ Thus, the rate of reoperation for complications within the DHS series was 11.8%, while the rate within the IMHS/GN series was 6.3%. For stable pertrochanteric fractures we therefore acknowledge DHS as the ideal implant in our opinion, while for all other extraarticular proximal fractures of the femur we recommend IMHS or GN.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Surgery in patients over 80 years of age--a retrospective analysis of 642 general surgery patients].
We evaluated the data on 642 patients over 80 years of age who underwent general surgery within the preceding 10 years. Lethality in elective surgery was higher compared to younger patients and showed a threefold increase in emergency procedures. Preexisting co-diseases strongly determined survival, which emphasises the fact that a thorough preoperative risk-assessment is essential for elective surgery. Age itself is not a contraindication for elective surgery.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
Comparative Study[Monitoring critically ill intensive care patients by semi-invasive COLD (Cardiac-Output-Liver-Diseases) monitoring instead of pulmonary artery catheterization].
The routine application of an arterial thermal-dye-dilution technique (so called COLD-Monitoring) offers new perspectives in the hemodynamic management of critically ill patients using a small invasive technique. COLD-Monitoring employs a computerized analysis of a double-indicator (temperature and dye) dilution technique which requires only a central venous catheter and a special fibre optic catheter with a temperature probe applied to the femoral artery. Especially in critically ill patients with septic course or multiple organ failure (MOF) COLD-monitoring serves to exactly measure volume and therefore distribution, to objectify capillary leakage by extravascular lung water index, to check the excretoric liver-function by plasma-deviation-rate of ICG and to perform a well controlled epinephrine therapy by measuring cardiac function index and systemic vascular resistance index.
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Langenbecks Arch Chir Suppl Kongressbd · Jan 1996
[Abdominal surgery in the elderly--a retrospective analysis over 11 years].
Particular problems of abdominal surgery in geriatric patients were analyzed in a retrospective study of 1569 surgical procedures of the abdomen carried out in 1420 patients aged 70 years or more. Emergency procedures were necessary in 357 (22.8%) cases with a lethality of 25.5% compared to 8.8% in the elective group. Morbidity was also visibly different in both groups (59.3% vs. 40.2%). While the average time of hospitalisation was 22.4 days, almost 80% of our patients could be released and 12.6% died in hospital.