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European Journal of Trauma and Emergency Surgery

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01.12.2011 | Review Article

Physiological assessment of the polytrauma patient: initial and secondary surgeries

verfasst von: N. Enninghorst, R. Peralta, O. Yoshino, R. Pfeifer, H. C. Pape, B. M. Hardy, D. C. Dewar, Z. J. Balogh

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 6/2011

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Abstract

The timing of fracture fixation in polytrauma patients has been debated for a long time. The decision between DCO (damage control orthopaedics) and ETC (early total care) is a difficult dilemma. Overzealous ETC in haemodynamically compromised patients with significant chest and head injuries can be detrimental. It has been shown, however, that early fracture fixation has a trend towards better outcome in patients with less severe injuries. Delaying all orthopaedic surgery in critically injured patients can be a safe alternative, but has several disadvantages like longer ICU stay and septic complications. The literature shows equivocal evidence for both settings. This article will summarize the historical background and controversies regarding patient assessment and decision making during the treatment of polytrauma patients. It will also give guidance for choosing DCO versus ETC in the clinical setting.

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Titel: Physiological assessment of the polytrauma patient: initial and secondary surgeries
verfasst von: N. Enninghorst
R. Peralta
O. Yoshino
R. Pfeifer
H. C. Pape
B. M. Hardy
D. C. Dewar
Z. J. Balogh
Publikationsdatum: 01.12.2011
Verlag: Springer-Verlag
Erschienen in: European Journal of Trauma and Emergency Surgery / Ausgabe 6/2011
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-011-0161-y

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Physiological assessment of the polytrauma patient: initial and secondary surgeries

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