Optimaler Zeitpunkt der Sekundäroperation bei Polytrauma Eine Evaluation an 4314 Schwerverletzten

Pape, H.-C.; Stalp, M.; Griensven, M. v.; Weinberg, Annelie M.; Dahlweit, M.; Tscherne, H.

doi:10.1007/s001040050781

Cited by 93 publications

(27 citation statements)

References 20 publications

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“…The early timing and short duration of initial pelvic stabilization revealed to have a positive impact on decreasing the incidence of multiple organ failure (MOF) and mortality [148]. Furthermore, post-injury complication rates were shown to be significantly increased when definitive pelvic ring fixation was performed between days 2 and 4, and decreased when surgery was delayed to days 6 to 8 post injury [149]. Many authors concur with the traditional concept of initial “damage control” external fixation of hemodynamically unstable pelvic ring injuries, and delayed definitive internal fixation after day 4, subsequent to successful resuscitative measures [28, 41, 58, 95, 118, 150–152].…”

Section: Methodsmentioning

confidence: 99%

Pelvic trauma: WSES classification and guidelines

et al. 2017

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Complex pelvic injuries are among the most dangerous and deadly trauma related lesions. Different classification systems exist, some are based on the mechanism of injury, some on anatomic patterns and some are focusing on the resulting instability requiring operative fixation. The optimal treatment strategy, however, should keep into consideration the hemodynamic status, the anatomic impairment of pelvic ring function and the associated injuries. The management of pelvic trauma patients aims definitively to restore the homeostasis and the normal physiopathology associated to the mechanical stability of the pelvic ring. Thus the management of pelvic trauma must be multidisciplinary and should be ultimately based on the physiology of the patient and the anatomy of the injury. This paper presents the World Society of Emergency Surgery (WSES) classification of pelvic trauma and the management Guidelines.

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Section: Methodsmentioning

confidence: 99%

Pelvic trauma: WSES classification and guidelines

et al. 2017

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“…In a large survey of over 4000 cases, the effects of the timing of surgery on MODS development were analyzed. Definitive osteosynthesis in patients who later developed MODS was performed between days 2 and 4, whereas patients without MODS were operated on between days 6 and 8 ( P < 0.0001) [20]. Therefore, the need for a waiting period of several days before definitive osteosynthesis has emerged.…”

Section: Damage Control Orthopedics (Dco)mentioning

confidence: 99%

Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients

Ratto

2013

ISRN Orthopedics

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The management of the polytraumatized orthopedic patient remains a challenging issue. In recent years many efforts have been made to develop rescue techniques and to promote guidelines for the management of these patients. Currently controversies persist between two orthopedic approaches: the Early Total Care and the Damage Control Orthopedics. An overview of the current literature on the orthopedic management of polytrauma patient is provided. Subsequently, femoral shaft fractures, representing extremely common lesions, and pelvic ring injuries, that are associated with a high mortality rate, are analyzed in detail.

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“…Une fois le patient stabilisé une fixation interne définitive est indiquée, après régression de la réaction inflammatoire et de l'œdème tissulaire. Selon certains auteurs la conversion doit être effectuée au minimum quatre jours après la chirurgie initiale [ 9 ].…”

Section: Discussionunclassified

L’intérêt du Trauma damage control orthopédique dans les polytraumatismes : un cas de disjonction du bassin associée à une luxation de la hanche avec atteinte vasculaire

Madani¹,

Alouani²,

Mhammdi³

et al. 2017

Pan Afr Med J

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La connaissance de la physiopathologie du traumatisé grave et les conséquences hémodynamiques et inflammatoires de la prise en charge chirurgicale initiale a amené de nombreux chirurgiens à modifier leur approche du traitement des polytraumatisé graves avec lésions du bassin ou des membres en intégrant les principes d'un traitement séquentiel ou Trauma Damage Control Orthopédique (TDCO).Nous rapportons le cas d'une patiente victime d'un accident de la voie publique, admise dans un tableau d'état de choc avec un disjonction du bassin associée à une luxation de la hanche compliquée d'une lésion vasculaire du même membre. Nous avons agit selon les concepts du TDCO en privilégiant une fixation externe du bassin après réduction de la luxation. La rapidité de notre conduite a permis une revascularisation précoce du membre tout en évitant les complications hémodynamiques et inflammatoires de la chirurgie à ciel ouvert.

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Optimaler Zeitpunkt der Sekundäroperation bei Polytrauma Eine Evaluation an 4314 Schwerverletzten

Abstract: In patients with severe trauma requiring secondary operations of > 3 h duration, performance of this operation should be avoided on post trauma days 2-4.

Cited by 93 publications

References 20 publications

Pelvic trauma: WSES classification and guidelines

Pelvic trauma: WSES classification and guidelines

Early Total Care versus Damage Control: Current Concepts in the Orthopedic Care of Polytrauma Patients

L’intérêt du Trauma damage control orthopédique dans les polytraumatismes : un cas de disjonction du bassin associée à une luxation de la hanche avec atteinte vasculaire

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