Damage control orthopedics

Lichte, Philipp; Kobbe, Philipp; Dombroski, Derek; Pape, H.-C.

doi:10.1097/mcc.0b013e328359fd57

Cited by 45 publications

(30 citation statements)

References 19 publications

(13 reference statements)

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“…It was also found that ETC in polytraumatized patients with major blood loss may increase significantly the severity of this inflammatory response (SIRS) as described by various authors [2,3,5,7,8]. The development of this hyper-inflammatory reaction is manifested by activation of the immune system which triggers increased secretion of pro-inflammatory cytokines, such as interleukin-6 (IL-6) and IL-8 [2,4].…”

Section: Introductionmentioning

confidence: 99%

“…Recently, an increasing research interest has been focused on the issue of cytokines and their role in immune activity in trauma patients [1][2][3][4][5]. Skeletal and tissue injuries may cause a hyper-inflammatory reaction of the immune system manifested by elevation in levels of pro-inflammatory cytokines and may lead to the development of systemic inflammatory reaction syndrome (SIRS).…”

Section: Introductionmentioning

confidence: 99%

“…The regular mode of treatment in the last few decades of patients with multiple injuries consists of immediate prolonged and extensive surgical procedures of isolated or combined head, chest and abdominal injuries followed by fixations of fractures of the pelvis and/or long bones of these patients and is called "early total care" (ETC). The secondary inflammatory reaction in such polytraumatized patients during and after surgical procedures, including immediate fracture fixation, is known as the "secondary hit" [2,3,5].…”

Section: Introductionmentioning

confidence: 99%

“…The basic principles of DCO are control of the life threatening injuries combined with minimal invasive stabilization of the fractures mainly by external fixators and then only after few days of metabolic and respiratory recovery to perform the definitive management of fracture fixation [2,5,7].…”

Section: Introductionmentioning

confidence: 99%

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Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Volpin

Cohen

Assaf

et al. 2014

International Orthopaedics (SICOT)

108

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Purpose Much research is now being conducted in order to understand the role of cytokines in the development of the inflammatory response following trauma. The purpose of this study was to evaluate whether serum levels of certain cytokines, measured immediately after initial injury, can be used as potential biomarkers for predicting the development and the degree of severity of the systemic inflammatory response (SIRS) in patients with moderate and severe trauma. Methods We conducted a prospective study with 71 individuals of whom 13 (18.3 %) were healthy controls and 58 (81.7 %) were traumatized orthopaedic patients who were categorized into two groups: 31 (43.6 %) with moderate injuries and 27 (38.1 %) patients with severe orthopaedic trauma. Thirty cc of heparinized blood were drawn from each individual within a few hours after the injury. Serum levels of pro-inflammatory, regulatory and anti-inflammatory cytokines were measured in each individual participant.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Volpin

Cohen

Assaf

et al. 2014

International Orthopaedics (SICOT)

108

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“…3,4 From this emerged the philosophy of "damage control". 5 Thus, the priority of surgical interventions, and the time to perform them, were dependent on the patient's physiological state. 6 In the field of orthopedics, these concepts have been well understood for the management of long bone and pelvic fractures in polytraumatized patients.…”

Section: Introductionmentioning

confidence: 99%

Damage control in thoracic and lumbar unstable fractures in polytrauma. Systematic review

Chávez¹,

Atanasio²,

García³

et al. 2015

Coluna/Columna

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The objective of this systematic review was to integrate the information from existing studies to determine the level of evidence and grade of recommendation of the implementation of damage control in unstable thoracic and lumbar fractures in polytraumatized patients. Eighteen papers were collected from different databases by keywords and Mesh terms; the level of evidence and grade of recommendation, the characteristics of the participants, the time of fracture fixation, the type of approach and technique used, the length of stay in the intensive care unit, the days of dependence on mechanical ventilator, and the incidence of complications in patients were assessed. The largest proportion of the studies were classified as level 4 evidence and grade C of recommendation which is favorable to the implementation of damage control in unstable thoracic and lumbar fractures in polytraumatized patients as a positive recommendation, although not conclusive. Most papers advocate fracture stabilization within 72 hours of the injury which is associated with a lower incidence of complications, hospital stay, stay in the intensive care unit and lower mortality. RESUMO O objetivo desta revisão sistemática foi integrar as informações dos estudos existentes para determinar o nível de evidência e grau de recomendação da aplicação do controle de danos em fraturas torácica e lombar instáveis em pacientes com politraumatismo. Foram incluídos 18 artigos encontrados em diferentes bancos de dados, usando-se palavras-chave e termos do MeSH; avaliaram-se: nível de evidência e grau de recomendação, características dos participantes, momento em que se realizou a fixação da fratura, tipo de acesso e a técnica utilizada, dias de permanência na unidade de terapia intensiva, os dias de dependência de ventilação mecânica e a incidência de complicações dos pacientes. A maior proporção de artigos foi classificada como nível 4 de evidência, com predomínio do grau C de recomendação, o que torna favorável à implementação do controle de danos em fraturas torácicas e lombares instáveis em pacientes com politraumatismo, não sendo, contudo, concludente. A maioria dos artigos preconiza a estabilização da fratura nas primeiras 72 horas da lesão, o que está associado a menor incidência de complicações, permanência hospitalar, permanência na unidade de terapia intensiva e a menor mortalidade. Descritores: Traumatismo múltiplo; Fraturas da coluna vertebral/cirurgia; Fixação de fratura; Vértebras lombares; Vértebras torácicas. RESUMEN El objetivo de esta revisión sistemática fue integrar la información de los estudios existentes para determinar el nivel de evidencia y grado de recomendación de la aplicación del control de daños en fracturas torácicas y lumbares inestables en pacientes politraumatizados. Se incluyeron 18 artículos localizados en diferentes bases de datos a través de palabras clave y términos del

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Initial Assessment and Diagnostics

Stahel

Olson

2022

Textbook of Polytrauma Management

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Damage control orthopedics

Abstract: In severely injured patients, DCO should be considered. On the other hand, there is still a lack of randomized studies for a more precise characterization of the patients who benefit from DCO treatment.

Cited by 45 publications

References 19 publications

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Cytokine Levels (IL-4, IL-6, IL-8 and TGFβ) as Potential Biomarkers of Systemic Inflammatory Response in Trauma Patients

Damage control in thoracic and lumbar unstable fractures in polytrauma. Systematic review

Initial Assessment and Diagnostics

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