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4. Enhanced perioperative care in emergency general surgery: the WSES position paper

Author

Ceresoli, M, Braga, M, Zanini, N, Abu-Zidan, F, Parini, D, Langer, T, Sartelli, M, Damaskos, D, Biffl, W, Amico, F, Ansaloni, L, Balogh, Z, Bonavina, L, Civil, I, Cicuttin, E, Chirica, M, Cui, Y, De Simone, B, Di Carlo, I, Fette, A, Foti, G, Fogliata, M, Fraga, G, Fugazzola, P, Galante, J, Beka, S, Hecker, A, Jeekel, J, Kirkpatrick, A, Koike, K, Leppaniemi, A, Marzi, I, Moore, E, Picetti, E, Pikoulis, E, Pisano, M, Podda, M, Sakakushev, B, Shelat, V, Tan, E, Tebala, G, Velmahos, G, Weber, D, Agnoletti, V, Kluger, Y, Baiocchi, G, Catena, F, Coccolini, F, Ceresoli M., Braga M., Zanini N., Abu-Zidan F. M., Parini D., Langer T., Sartelli M., Damaskos D., Biffl W. L., Amico F., Ansaloni L., Balogh Z. J., Bonavina L., Civil I., Cicuttin E., Chirica M., Cui Y., De Simone B., Di Carlo I., Fette A., Foti G., Fogliata M., Fraga G. P., Fugazzola P., Galante J. M., Beka S. G., Hecker A., Jeekel J., Kirkpatrick A. W., Koike K., Leppaniemi A., Marzi I., Moore E. E., Picetti E., Pikoulis E., Pisano M., Podda M., Sakakushev B. E., Shelat V. G., Tan E., Tebala G. D., Velmahos G., Weber D. G., Agnoletti V., Kluger Y., Baiocchi G., Catena F., Coccolini F., Ceresoli, M, Braga, M, Zanini, N, Abu-Zidan, F, Parini, D, Langer, T, Sartelli, M, Damaskos, D, Biffl, W, Amico, F, Ansaloni, L, Balogh, Z, Bonavina, L, Civil, I, Cicuttin, E, Chirica, M, Cui, Y, De Simone, B, Di Carlo, I, Fette, A, Foti, G, Fogliata, M, Fraga, G, Fugazzola, P, Galante, J, Beka, S, Hecker, A, Jeekel, J, Kirkpatrick, A, Koike, K, Leppaniemi, A, Marzi, I, Moore, E, Picetti, E, Pikoulis, E, Pisano, M, Podda, M, Sakakushev, B, Shelat, V, Tan, E, Tebala, G, Velmahos, G, Weber, D, Agnoletti, V, Kluger, Y, Baiocchi, G, Catena, F, Coccolini, F, Ceresoli M., Braga M., Zanini N., Abu-Zidan F. M., Parini D., Langer T., Sartelli M., Damaskos D., Biffl W. L., Amico F., Ansaloni L., Balogh Z. J., Bonavina L., Civil I., Cicuttin E., Chirica M., Cui Y., De Simone B., Di Carlo I., Fette A., Foti G., Fogliata M., Fraga G. P., Fugazzola P., Galante J. M., Beka S. G., Hecker A., Jeekel J., Kirkpatrick A. W., Koike K., Leppaniemi A., Marzi I., Moore E. E., Picetti E., Pikoulis E., Pisano M., Podda M., Sakakushev B. E., Shelat V. G., Tan E., Tebala G. D., Velmahos G., Weber D. G., Agnoletti V., Kluger Y., Baiocchi G., Catena F., and Coccolini F.

Abstract

Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients’ outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023

5. ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings

Author

Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., Ansaloni L., Frassini, S, Cobianchi, L, Fugazzola, P, Biffl, W, Coccolini, F, Damaskos, D, Moore, E, Kluger, Y, Ceresoli, M, Coimbra, R, Davies, J, Kirkpatrick, A, Di Carlo, I, Hardcastle, T, Isik, A, Chiarugi, M, Gurusamy, K, Maier, R, Segovia Lohse, H, Jeekel, H, Boermeester, M, Abu-Zidan, F, Inaba, K, Weber, D, Augustin, G, Bonavina, L, Velmahos, G, Sartelli, M, Di Saverio, S, Ten Broek, R, Granieri, S, Dal Mas, F, Fare, C, Peverada, J, Zanghi, S, Vigano, J, Tomasoni, M, Dominioni, T, Cicuttin, E, Hecker, A, Tebala, G, Galante, J, Wani, I, Khokha, V, Sugrue, M, Scalea, T, Tan, E, Malangoni, M, Pararas, N, Podda, M, De Simone, B, Ivatury, R, Cui, Y, Kashuk, J, Peitzman, A, Kim, F, Pikoulis, E, Sganga, G, Chiara, O, Kelly, M, Marzi, I, Picetti, E, Agnoletti, V, De'Angelis, N, Campanelli, G, de Moya, M, Litvin, A, Martinez-Perez, A, Sall, I, Rizoli, S, Tomadze, G, Sakakushev, B, Stahel, P, Civil, I, Shelat, V, Costa, D, Chichom-Mefire, A, Latifi, R, Chirica, M, Amico, F, Pardhan, A, Seenarain, V, Boyapati, N, Hatz, B, Ackermann, T, Abeyasundara, S, Fenton, L, Plani, F, Sarvepalli, R, Rouhbakhshfar, O, Caleo, P, Ho-Ching Yau, V, Clement, K, Christou, E, Castillo, A, Gosal, P, Balasubramaniam, S, Hsu, J, Banphawatanarak, K, Pisano, M, Adriana, T, Michele, A, Cioffi, S, Spota, A, Catena, F, Ansaloni, L, Frassini S., Cobianchi L., Fugazzola P., Biffl W. L., Coccolini F., Damaskos D., Moore E. E., Kluger Y., Ceresoli M., Coimbra R., Davies J., Kirkpatrick A., Di Carlo I., Hardcastle T. C., Isik A., Chiarugi M., Gurusamy K., Maier R. V., Segovia Lohse H. A., Jeekel H., Boermeester M. A., Abu-Zidan F., Inaba K., Weber D. G., Augustin G., Bonavina L., Velmahos G., Sartelli M., Di Saverio S., Ten Broek R. P. G., Granieri S., Dal Mas F., Fare C. N., Peverada J., Zanghi S., Vigano J., Tomasoni M., Dominioni T., Cicuttin E., Hecker A., Tebala G. D., Galante J. M., Wani I., Khokha V., Sugrue M., Scalea T. M., Tan E., Malangoni M. A., Pararas N., Podda M., De Simone B., Ivatury R., Cui Y., Kashuk J., Peitzman A., Kim F., Pikoulis E., Sganga G., Chiara O., Kelly M. D., Marzi I., Picetti E., Agnoletti V., De'Angelis N., Campanelli G., de Moya M., Litvin A., Martinez-Perez A., Sall I., Rizoli S., Tomadze G., Sakakushev B., Stahel P. F., Civil I., Shelat V., Costa D., Chichom-Mefire A., Latifi R., Chirica M., Amico F., Pardhan A., Seenarain V., Boyapati N., Hatz B., Ackermann T., Abeyasundara S., Fenton L., Plani F., Sarvepalli R., Rouhbakhshfar O., Caleo P., Ho-Ching Yau V., Clement K., Christou E., Castillo A. M. G., Gosal P. K. S., Balasubramaniam S., Hsu J., Banphawatanarak K., Pisano M., Adriana T., Michele A., Cioffi S. P. B., Spota A., Catena F., and Ansaloni L.

Abstract

Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Published
2023

6. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author

De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, Catena, F, De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., and Catena F.

Abstract

Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classificat

Published
2023

9. Kindliches Polytrauma

Author

Störmann, P., Auner, B., Wutzler, S., Marzi, I., Pape, Hans-Christoph, editor, Hildebrand, Frank, editor, and Ruchholtz, Steffen, editor

Published
2018
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16. Fuß

Author

Schneidmüller, D., Voth, M., Marzi, I., and Marzi, Ingo, editor

Published
2016
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17. Knie

Author

Schneidmüller, D., Rose, S., Frank, J., Marzi, I., and Marzi, Ingo, editor

Published
2016
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19. Becken

Author

Thannheimer, A., Marzi, I., Bühren, V., and Marzi, Ingo, editor

Published
2016
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21. Hand

Author

Frank, J., Marzi, I., and Marzi, Ingo, editor

Published
2016
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23. Ellenbogen

Author

Wessel, L. M., Schneidmüller, D., Weinberg, A., Castellani, C., Rose, S., Marzi, I., and Marzi, Ingo, editor

Published
2016
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25. The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study

Author

De Simone B., Kluger Y., Moore E. E., Sartelli M., Abu-Zidan F. M., Coccolini F., Ansaloni L., Tebala G. D., Di Saverio S., Di Carlo I., Sakakushev B. E., Bonavina L., Sugrue M., Galante J. M., Ivatury R., Picetti E., Chirica M., Wani I., Bala M., Sall I., Kirkpatrick A. W., Shelat V. G., Pikoulis E., Leppäniemi A., Tan E., Broek R. P. G. t., Gurmu Beka S., Litvin A., Chouillard E., Coimbra R., Cui Y., De’ Angelis N., Sganga G., Stahel P. F., Agnoletti V., Rampini A., Shelat V., Damaskos D., Carcoforo P., Biffl W. L., Hecker A., Kirkpatrick A., Di Salomone S., Balogh Z., Beka S. G., Broek R. T., Velmahos G., Sakakushev B., Ceresoli M., Chiara O., Stahel P., Leppaniemi A., Marzi I., Inaba K., Khokha V., Reva V., Khan M., Toro A., de’ Angelis N., Malangoni M., Scozzafava E., Civil I., Maier R., Weber D., Chiarugi M., Soreide K., Testini M., Bravi F., Maier R. V., Catena F., De Simone, B, Kluger, Y, Moore, E, Sartelli, M, Abu-Zidan, F, Coccolini, F, Ansaloni, L, Tebala, G, Di Saverio, S, Di Carlo, I, Sakakushev, B, Bonavina, L, Sugrue, M, Galante, J, Ivatury, R, Picetti, E, Chirica, M, Wani, I, Bala, M, Sall, I, Kirkpatrick, A, Shelat, V, Pikoulis, E, Leppäniemi, A, Tan, E, Broek, R, Gurmu Beka, S, Litvin, A, Chouillard, E, Coimbra, R, Cui, Y, De’ Angelis, N, Sganga, G, Stahel, P, Agnoletti, V, Rampini, A, Damaskos, D, Carcoforo, P, Biffl, W, Hecker, A, Di Salomone, S, Balogh, Z, Beka, S, Velmahos, G, Ceresoli, M, Chiara, O, Leppaniemi, A, Marzi, I, Inaba, K, Khokha, V, Reva, V, Khan, M, Toro, A, de’ Angelis, N, Malangoni, M, Scozzafava, E, Civil, I, Maier, R, Weber, D, Chiarugi, M, Soreide, K, Testini, M, Bravi, F, and Catena, F

Subjects
Healthcare system, Delay in surgery, Operating room management, Delphi method, Emergency surgery, Priority, Time to surgery, Timing in acute care surgery (TACS), Triage, Classification
Abstract

Background: Timely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The “timing in acute care surgery” (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts. Methods: This is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4–5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease. Results: Four polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority. Conclusion: The new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a “safe” timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.

Published
2023

26. The LIFE TRIAD of emergency general surgery

Author

Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, Coccolini F., Sartelli M., Kluger Y., Osipov A., Cui Y., Beka S. G., Kirkpatrick A., Sall I., Moore E. E., Biffl W. L., Litvin A., Pisano M., Magnone S., Picetti E., de Angelis N., Stahel P., Ansaloni L., Tan E., Abu-Zidan F., Ceresoli M., Hecker A., Chiara O., Sganga G., Khokha V., di Saverio S., Sakakushev B., Campanelli G., Fraga G., Wani I., Broek R., Cicuttin E., Cremonini C., Tartaglia D., Soreide K., Galante J., de Moya M., Koike K., De Simone B., Balogh Z., Amico F., Shelat V., Pikoulis E., Di Carlo I., Bonavina L., Leppaniemi A., Marzi I., Ivatury R., Khan J., Maier R. V., Hardcastle T. C., Isik A., Podda M., Tolonen M., Rasa K., Navsaria P. H., Demetrashvili Z., Tarasconi A., Carcoforo P., Sibilla M. G., Baiocchi G. L., Pararas N., Weber D., Chiarugi M., Catena F., Coccolini, F, Sartelli, M, Kluger, Y, Osipov, A, Cui, Y, Beka, S, Kirkpatrick, A, Sall, I, Moore, E, Biffl, W, Litvin, A, Pisano, M, Magnone, S, Picetti, E, de Angelis, N, Stahel, P, Ansaloni, L, Tan, E, Abu-Zidan, F, Ceresoli, M, Hecker, A, Chiara, O, Sganga, G, Khokha, V, di Saverio, S, Sakakushev, B, Campanelli, G, Fraga, G, Wani, I, Broek, R, Cicuttin, E, Cremonini, C, Tartaglia, D, Soreide, K, Galante, J, de Moya, M, Koike, K, De Simone, B, Balogh, Z, Amico, F, Shelat, V, Pikoulis, E, Di Carlo, I, Bonavina, L, Leppaniemi, A, Marzi, I, Ivatury, R, Khan, J, Maier, R, Hardcastle, T, Isik, A, Podda, M, Tolonen, M, Rasa, K, Navsaria, P, Demetrashvili, Z, Tarasconi, A, Carcoforo, P, Sibilla, M, Baiocchi, G, Pararas, N, Weber, D, Chiarugi, M, Catena, F, Coccolini F., Sartelli M., Kluger Y., Osipov A., Cui Y., Beka S. G., Kirkpatrick A., Sall I., Moore E. E., Biffl W. L., Litvin A., Pisano M., Magnone S., Picetti E., de Angelis N., Stahel P., Ansaloni L., Tan E., Abu-Zidan F., Ceresoli M., Hecker A., Chiara O., Sganga G., Khokha V., di Saverio S., Sakakushev B., Campanelli G., Fraga G., Wani I., Broek R., Cicuttin E., Cremonini C., Tartaglia D., Soreide K., Galante J., de Moya M., Koike K., De Simone B., Balogh Z., Amico F., Shelat V., Pikoulis E., Di Carlo I., Bonavina L., Leppaniemi A., Marzi I., Ivatury R., Khan J., Maier R. V., Hardcastle T. C., Isik A., Podda M., Tolonen M., Rasa K., Navsaria P. H., Demetrashvili Z., Tarasconi A., Carcoforo P., Sibilla M. G., Baiocchi G. L., Pararas N., Weber D., Chiarugi M., and Catena F.

Abstract

Emergency General Surgery (EGS) was identified as multidisciplinary surgery performed for traumatic and non-traumatic acute conditions during the same admission in the hospital by general emergency surgeons and other specialists. It is the most diffused surgical discipline in the world. To live and grow strong EGS necessitates three fundamental parts: emergency and elective continuous surgical practice, evidence generation through clinical registries and data accrual, and indications and guidelines production: the LIFE TRIAD.

Published
2022

27. The acute phase management of spinal cord injury affecting polytrauma patients: the ASAP study

Author

Picetti, E, Iaccarino, C, Coimbra, R, Abu-Zidan, F, Tebala, G, Balogh, Z, Biffl, W, Coccolini, F, Gupta, D, Maier, R, Marzi, I, Robba, C, Sartelli, M, Servadei, F, Stahel, P, Taccone, F, Unterberg, A, Antonini, M, Galante, J, Ansaloni, L, Kirkpatrick, A, Rizoli, S, Leppaniemi, A, Chiara, O, De Simone, B, Chirica, M, Shelat, V, Fraga, G, Ceresoli, M, Cattani, L, Minardi, F, Tan, E, Wani, I, Petranca, M, Domenichelli, F, Cui, Y, Malchiodi, L, Sani, E, Litvin, A, Hecker, A, Montanaro, V, Beka, S, Di Saverio, S, Rossi, S, Catena, F, Picetti E., Iaccarino C., Coimbra R., Abu-Zidan F., Tebala G. D., Balogh Z. J., Biffl W. L., Coccolini F., Gupta D., Maier R. V., Marzi I., Robba C., Sartelli M., Servadei F., Stahel P. F., Taccone F. S., Unterberg A. W., Antonini M. V., Galante J. M., Ansaloni L., Kirkpatrick A. W., Rizoli S., Leppaniemi A., Chiara O., De Simone B., Chirica M., Shelat V. G., Fraga G. P., Ceresoli M., Cattani L., Minardi F., Tan E., Wani I., Petranca M., Domenichelli F., Cui Y., Malchiodi L., Sani E., Litvin A., Hecker A., Montanaro V., Beka S. G., Di Saverio S., Rossi S., Catena F., Picetti, E, Iaccarino, C, Coimbra, R, Abu-Zidan, F, Tebala, G, Balogh, Z, Biffl, W, Coccolini, F, Gupta, D, Maier, R, Marzi, I, Robba, C, Sartelli, M, Servadei, F, Stahel, P, Taccone, F, Unterberg, A, Antonini, M, Galante, J, Ansaloni, L, Kirkpatrick, A, Rizoli, S, Leppaniemi, A, Chiara, O, De Simone, B, Chirica, M, Shelat, V, Fraga, G, Ceresoli, M, Cattani, L, Minardi, F, Tan, E, Wani, I, Petranca, M, Domenichelli, F, Cui, Y, Malchiodi, L, Sani, E, Litvin, A, Hecker, A, Montanaro, V, Beka, S, Di Saverio, S, Rossi, S, Catena, F, Picetti E., Iaccarino C., Coimbra R., Abu-Zidan F., Tebala G. D., Balogh Z. J., Biffl W. L., Coccolini F., Gupta D., Maier R. V., Marzi I., Robba C., Sartelli M., Servadei F., Stahel P. F., Taccone F. S., Unterberg A. W., Antonini M. V., Galante J. M., Ansaloni L., Kirkpatrick A. W., Rizoli S., Leppaniemi A., Chiara O., De Simone B., Chirica M., Shelat V. G., Fraga G. P., Ceresoli M., Cattani L., Minardi F., Tan E., Wani I., Petranca M., Domenichelli F., Cui Y., Malchiodi L., Sani E., Litvin A., Hecker A., Montanaro V., Beka S. G., Di Saverio S., Rossi S., and Catena F.

Abstract

Background: Few data on the management of acute phase of traumatic spinal cord injury (tSCI) in patients suffering polytrauma are available. As the therapeutic choices in the first hours may have a deep impact on outcome of tSCI patients, we conducted an international survey investigating this topic. Methods: The survey was composed of 29 items. The main endpoints of the survey were to examine: (1) the hemodynamic and respiratory management, (2) the coagulation management, (3) the timing of magnetic resonance imaging (MRI) and spinal surgery, (4) the use of corticosteroid therapy, (5) the role of intraspinal pressure (ISP)/spinal cord perfusion pressure (SCPP) monitoring and (6) the utilization of therapeutic hypothermia. Results: There were 171 respondents from 139 centers worldwide. A target mean arterial pressure (MAP) target of 80–90 mmHg was chosen in almost half of the cases [n = 84 (49.1%)]. A temporary reduction in the target MAP, for the time strictly necessary to achieve bleeding control in polytrauma, was accepted by most respondents [n = 100 (58.5%)]. Sixty-one respondents (35.7%) considered acceptable a hemoglobin (Hb) level of 7 g/dl in tSCI polytraumatized patients. An arterial partial pressure of oxygen (PaO2) of 80–100 mmHg [n = 94 (55%)] and an arterial partial pressure of carbon dioxide (PaCO2) of 35–40 mmHg [n = 130 (76%)] were chosen in most cases. A little more than half of respondents considered safe a platelet (PLT) count > 100.000/mm3 [n = 99 (57.9%)] and prothrombin time (PT)/activated partial thromboplastin time (aPTT) < 1.5 times the normal control [n = 85 (49.7%)] in patients needing spinal surgery. MRI [n = 160 (93.6%)] and spinal surgery [n = 158 (92.4%)] should be performed after intracranial, hemodynamic, and respiratory stabilization by most respondents. Corticosteroids [n = 103 (60.2%)], ISP/SCPP monitoring [n = 148 (86.5%)], and therapeutic hypothermia [n = 137 (80%)] were not utilized by most respondents. Conclusions: Our s

Published
2022

33. ECLAPTE: Effective Closure of LAParoTomy in Emergency-2023 World Society of Emergency Surgery guidelines for the closure of laparotomy in emergency settings.

Author

Frassini, S., Cobianchi, L., Fugazzola, P., Biffl, W.L., Coccolini, F., Damaskos, D., Moore, E.E., Kluger, Y., Ceresoli, M., Coimbra, R., Davies, J., Kirkpatrick, A., Carlo, I. Di, Hardcastle, T.C., Isik, A., Chiarugi, M., Gurusamy, K., Maier, R.V., Segovia Lohse, H.A., Jeekel, H., Boermeester, M.A., Abu-Zidan, F., Inaba, K., Weber, D.G., Augustin, G., Bonavina, L., Velmahos, G., Sartelli, M., Saverio, S. Di, Broek, R.P.G ten, Granieri, S., Mas, F. Dal, Farè, C.N., Peverada, J., Zanghì, S., Viganò, J., Tomasoni, M., Dominioni, T., Cicuttin, E., Hecker, A., Tebala, G.D., Galante, J.M., Wani, I., Khokha, V., Sugrue, M., Scalea, T.M., Tan, E.C.T.H., Malangoni, M.A., Pararas, N., Podda, M., Simone, B. De, Ivatury, R., Cui, Y., Kashuk, J., Peitzman, A., Kim, F., Pikoulis, E., Sganga, G., Chiara, O., Kelly, M.D., Marzi, I., Picetti, E., Agnoletti, V., De'Angelis, N., Campanelli, G., Moya, M. de, Litvin, A., Martínez-Pérez, A., Sall, I., Rizoli, S., Tomadze, G., Sakakushev, B., Stahel, P.F., Civil, I., Shelat, V., Costa, D., Chichom-Mefire, A., Latifi, R., Chirica, M., Amico, F., Pardhan, A., Seenarain, V., Boyapati, N., Hatz, B., Ackermann, T., Abeyasundara, S., Fenton, L., Plani, F., Sarvepalli, R., Rouhbakhshfar, O., Caleo, P., Ho-Ching Yau, V., Clement, K., Christou, E., Castillo, A.M.G., Gosal, P.K.S., Balasubramaniam, S., Hsu, J., Banphawatanarak, K., Pisano, M., Adriana, T., Michele, A., Cioffi, S.P.B., Spota, A., Catena, F., Ansaloni, L., Frassini, S., Cobianchi, L., Fugazzola, P., Biffl, W.L., Coccolini, F., Damaskos, D., Moore, E.E., Kluger, Y., Ceresoli, M., Coimbra, R., Davies, J., Kirkpatrick, A., Carlo, I. Di, Hardcastle, T.C., Isik, A., Chiarugi, M., Gurusamy, K., Maier, R.V., Segovia Lohse, H.A., Jeekel, H., Boermeester, M.A., Abu-Zidan, F., Inaba, K., Weber, D.G., Augustin, G., Bonavina, L., Velmahos, G., Sartelli, M., Saverio, S. Di, Broek, R.P.G ten, Granieri, S., Mas, F. Dal, Farè, C.N., Peverada, J., Zanghì, S., Viganò, J., Tomasoni, M., Dominioni, T., Cicuttin, E., Hecker, A., Tebala, G.D., Galante, J.M., Wani, I., Khokha, V., Sugrue, M., Scalea, T.M., Tan, E.C.T.H., Malangoni, M.A., Pararas, N., Podda, M., Simone, B. De, Ivatury, R., Cui, Y., Kashuk, J., Peitzman, A., Kim, F., Pikoulis, E., Sganga, G., Chiara, O., Kelly, M.D., Marzi, I., Picetti, E., Agnoletti, V., De'Angelis, N., Campanelli, G., Moya, M. de, Litvin, A., Martínez-Pérez, A., Sall, I., Rizoli, S., Tomadze, G., Sakakushev, B., Stahel, P.F., Civil, I., Shelat, V., Costa, D., Chichom-Mefire, A., Latifi, R., Chirica, M., Amico, F., Pardhan, A., Seenarain, V., Boyapati, N., Hatz, B., Ackermann, T., Abeyasundara, S., Fenton, L., Plani, F., Sarvepalli, R., Rouhbakhshfar, O., Caleo, P., Ho-Ching Yau, V., Clement, K., Christou, E., Castillo, A.M.G., Gosal, P.K.S., Balasubramaniam, S., Hsu, J., Banphawatanarak, K., Pisano, M., Adriana, T., Michele, A., Cioffi, S.P.B., Spota, A., Catena, F., and Ansaloni, L.

Abstract

Contains fulltext : 296003.pdf (Publisher’s version ) (Open Access), Laparotomy incisions provide easy and rapid access to the peritoneal cavity in case of emergency surgery. Incisional hernia (IH) is a late manifestation of the failure of abdominal wall closure and represents frequent complication of any abdominal incision: IHs can cause pain and discomfort to the patients but also clinical serious sequelae like bowel obstruction, incarceration, strangulation, and necessity of reoperation. Previous guidelines and indications in the literature consider elective settings and evidence about laparotomy closure in emergency settings is lacking. This paper aims to present the World Society of Emergency Surgery (WSES) project called ECLAPTE (Effective Closure of LAParoTomy in Emergency): the final manuscript includes guidelines on the closure of emergency laparotomy.

Published
2023

34. Enhanced perioperative care in emergency general surgery: the WSES position paper.

Author

Ceresoli, M., Braga, M., Zanini, N., Abu-Zidan, F.M., Parini, D., Langer, T., Sartelli, M., Damaskos, D., Biffl, W.L., Amico, F., Ansaloni, L., Balogh, Z.J., Bonavina, L., Civil, I., Cicuttin, E., Chirica, M., Cui, Y., Simone, B. De, Carlo, I. Di, Fette, A., Foti, G., Fogliata, M., Fraga, G.P., Fugazzola, P., Galante, J.M., Beka, S.G., Hecker, A., Jeekel, J., Kirkpatrick, A.W., Koike, Kaoru, Leppäniemi, A., Marzi, I., Moore, E.E., Picetti, E., Pikoulis, E., Pisano, M., Podda, M., Sakakushev, B.E., Shelat, V.G., Tan, E.C.T.H., Tebala, G.D., Velmahos, G., Weber, D.G., Agnoletti, V., Kluger, Y., Baiocchi, G., Catena, F., Coccolini, F., Ceresoli, M., Braga, M., Zanini, N., Abu-Zidan, F.M., Parini, D., Langer, T., Sartelli, M., Damaskos, D., Biffl, W.L., Amico, F., Ansaloni, L., Balogh, Z.J., Bonavina, L., Civil, I., Cicuttin, E., Chirica, M., Cui, Y., Simone, B. De, Carlo, I. Di, Fette, A., Foti, G., Fogliata, M., Fraga, G.P., Fugazzola, P., Galante, J.M., Beka, S.G., Hecker, A., Jeekel, J., Kirkpatrick, A.W., Koike, Kaoru, Leppäniemi, A., Marzi, I., Moore, E.E., Picetti, E., Pikoulis, E., Pisano, M., Podda, M., Sakakushev, B.E., Shelat, V.G., Tan, E.C.T.H., Tebala, G.D., Velmahos, G., Weber, D.G., Agnoletti, V., Kluger, Y., Baiocchi, G., Catena, F., and Coccolini, F.

Abstract

Contains fulltext : 297347.pdf (Publisher’s version ) (Open Access), Enhanced perioperative care protocols become the standard of care in elective surgery with a significant improvement in patients' outcome. The key element of the enhanced perioperative care protocol is the multimodal and interdisciplinary approach targeted to the patient, focused on a holistic approach to reduce surgical stress and improve perioperative recovery. Enhanced perioperative care in emergency general surgery is still a debated topic with little evidence available. The present position paper illustrates the existing evidence about perioperative care in emergency surgery patients with a focus on each perioperative intervention in the preoperative, intraoperative and postoperative phase. For each item was proposed and approved a statement by the WSES collaborative group.

Published
2023

35. Concepts, utilization, and perspectives on the Dutch Nationwide Trauma registry: a position paper

Author

MCS-team, Heelkunde Opleiding, Cardiologie Arts-onderzoekers, Zorgeenheid Traumatologie, Other research (not in main researchprogram), Epi Methoden Team 1, Infection & Immunity, Hoepelman, R. J., Driessen, M. L.S., de Jongh, M. A.C., Houwert, R. M., Marzi, I., Lecky, F., Lefering, R., van de Wall, B. J.M., Beeres, F. J.P., Dijkgraaf, M. G.W., Groenwold, R. H.H., Leenen, L. P.H., MCS-team, Heelkunde Opleiding, Cardiologie Arts-onderzoekers, Zorgeenheid Traumatologie, Other research (not in main researchprogram), Epi Methoden Team 1, Infection & Immunity, Hoepelman, R. J., Driessen, M. L.S., de Jongh, M. A.C., Houwert, R. M., Marzi, I., Lecky, F., Lefering, R., van de Wall, B. J.M., Beeres, F. J.P., Dijkgraaf, M. G.W., Groenwold, R. H.H., and Leenen, L. P.H.

Published
2023

38. Interventionelle Notfallembolisation bei schweren Beckenfrakturen mit arterieller Blutung

Author

Westhoff, J., Laurer, H., Wutzler, S., Wyen, H., Mack, M., Maier, B., and Marzi, I.

Abstract

Zusammenfassung: Zielsetzung: Vorstellung eigener Erfahrungen und Ergebnisse eines frühklinischen Behandlungsalgorithmus unter Integration der Notfallembolisation (TAE) bei instabilen Beckenfrakturen mit arterieller Blutung. Methodik: Retrospektive Untersuchung einer konsekutiven Patientenserie der Jahre 04/2002-12/2006 an einem Level-1-Traumacenter. Die Daten der Online-Schockraumdokumentation (Traumawatch®) bei Patienten mit Beckenfraktur und einer im Multislice-Computertomographie (MSCT) nachgewiesenen arteriellen Blutung wurden auf folgende Parameter hin untersucht: demographische Daten, Unfallmechanismus, Frakturklassifikation nach Tile/AO und Verletzungsschwere Becken nach „Abbreviated Injury Score“ (AIS), Begleitverletzungen mit Erhebung der Gesamtverletzungsschwere nach „Injury Severety Score“ (ISS), physiologische Aufnahmeparameter (Kreislaufparameter und initialer Hb-Wert) sowie Transfusionsbedarf während der Schockraumversorgung, Zeit bis zur Embolisation, Dauer der Embolisation und identifizierte Blutungsquelle. Ergebnisse: Von insgesamt 162 Schockraumpatienten mit instabiler Beckenfraktur wurde bei 21 Patienten eine arterielle Blutung durch Kontrastmittelextravasation im MSCT nachgewiesen. 12 Patienten waren männlich und 9 weiblich, das Durchschnittsalter lag bei 45 (17–80) Jahre. Als Unfallmechanismus lagen ausschließlich Hochrasanztraumen vor. Es handelte sich zu 33% um Becken-B-Verletzungen und 67% um Typ-C-Verletzungen mit einem durchschnittlichen AISBecken von 4,4 Punkte (3-5) und einer Gesamtverletzungsschwere anhand des ISS von 37 Punkte (21–66). Bei Aufnahme lag bei 47,6% eine Kreislaufinstabilität vor mit einem durchschnittlichen Hb-Wert von 7,8 (3,2–12,4) g/dl und einem durchschnittlichen Transfusionsbedarf von 6 (4–13) Erythrozytenkonzentraten während der Stabilisierungsphase. Die Zeit von Eintreffen im Schockraum bis zur Durchführung der TAE betrug im Mittel 62 (25–115) min mit einer Durchführungsdauer der TAE von 25 (15–67) min. Als Blutungsquelle wurden ausschließlich Äste der A. iliaca interna identifiziert. Die primäre Erfolgsrate der TAE betrug >90%. Schlussfolgerung: Die interventionelle Notfallembolisation (TAE) stellt sowohl ein effektives als auch schnelles Verfahren zur Blutstillung bei einer im MSCT nachgewiesenen arteriellen Blutung bei Schockraumpatienten mit stabilen oder stabilisierbaren Kreislaufverhältnissen und Beckenfrakturen dar. Bei gesicherter 24-h-Bereitschaft durch die Radiologie und effizienter Infrastruktur kann diese zeitnah nach Klinikaufnahme durchgeführt werden und sollte somit in das frühklinische Behandlungsprotokoll integriert werden.

Published
2024
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39. Entwicklung des Lernzielkatalogs „Muskuloskelettale Erkrankungen, Verletzungen und traumatische Notfälle“ für Orthopädie-Unfallchirurgie im Medizinstudium

Author

Walcher, F., Dreinhöfer, K.E., Obertacke, U., Waydhas, C., Josten, C., Rüsseler, M., Venbrocks, R.-A., Liener, U., Marzi, I., Forst, R., and Nast-Kolb, D.

Abstract

Zusammenfassung: Hintergrund: Mit der Entwicklung des gemeinsamen Faches Orthopädie-Unfallchirurgie bedarf es neben der Zusammenführung und Überarbeitung der Weiterbildungsinhalte des ärztlichen Nachwuchses auch der Erstellung eines für Deutschland einheitlichen Lernzielkatalogs, der die Grundlage der studentischen Lehre in der Orthopädie und Unfallchirurgie an den deutschen Fakultäten und Lehrkrankenhäusern bilden soll. Material und Methode: Ausgehend vom Frankfurter Lernzielkatalog für Unfallchirurgie und dem Ulmer Lernzielkatalog für Orthopädie wurde von einer Expertenkommission der gemeinsame Katalog für das Fach Orthopädie und Unfallchirurgie entwickelt. Durch Vertreter beider Fächer erfolgte die Definition der Lernziele und anschließende Gliederung und Priorisierung in sog. Ebenen und Bereiche des kognitiven Wissens, Kompetenzstufen psychomotorischer Fertigkeiten (Skills) sowie emotionales Wissen und Kompetenz. Ergebnis: Insgesamt wurden 283 Lernziele formuliert. Der „allgemeine Teil operativer Fachgebiete“ umfasst 120 Lernziele, die sich in 39 Items kognitiven Inhalts und 83 Skills unterteilen, 2 Lernziele beinhalten gleichzeitig sowohl Wissen als auch Skills. Der „spezielle Teil Orthopädie/Unfallchirurgie“ umfasst insgesamt 141 Lernziele unterteilt in 138 Lernziele mit Wissensinhalten sowie 6 Skills, 3 Lernziele beziehen sich auf Wissen sowie Skills. 22 Lerninhalte beziehen sich auf den Bereich „emotionales Wissen und Kompetenz“. Schlussfolgerung: Trotz der erst jungen Verbindung der beiden Fächer Orthopädie und Unfallchirurgie konnte nicht nur eine „Themensammlung“, sondern ein gemeinsamer Lernzielkatalog für die studentische Lehre erarbeitet werden. Dieser hat nach der Verabschiedung durch die Ordinarienkonvente der Unfallchirurgen und Orthopäden bundesweiten Empfehlungscharakter. Mit der Konsentierung von Lernzielen sind die Weichen für eine zukunftorientierte moderne Lehre gestellt. Anhand der im Lernzielkatalog enthaltenen Empfehlungen zur Gewichtung der Inhalte, zur Verknüpfung mit anderen Fächern und zum Einsatz geeigneter Lehrmethoden, können die einzelnen Lernziele an den jeweiligen Fakultäten pragmatisch und unter Wahrung der Freiheit der Lehre umgesetzt werden.

Published
2024
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40. Veränderungen in der Alterstraumatologie

Author

Wutzler, S., Lefering, R., Laurer, H.L., Walcher, F., Wyen, H., and Marzi, I.

Abstract

Zusammenfassung: Das steigende Durchschnittsalter der Bevölkerung in den Industrienationen führt zu einer steigenden Anzahl verunfallter Patienten im höheren Lebensalter, die eine Analyse der altersspezifischen Besonderheiten erfordert. In der vorliegenden Studie erfolgte eine Analyse an 14.869 Patienten über 18 Jahre, die 1996–2005 prospektiv im Traumaregister der Deutschen Gesellschaft für Unfallchirurgie erfasst wurden. Patienten im Alter zwischen 18 und 59 Jahren wurden als Vergleichskollektiv betrachtet; ihr Anteil sank im Jahresvergleich 1996-2000 mit 2001–2005 von 81,1% auf 75,4%. In diesem Kollektiv erwachsener Traumapatienten stieg das Altersmittel von 41,0 Jahren in 1996 auf 45,3 Jahre in 2005. Mit steigendem Alter zeigte sich eine deutliche Zunahme des Anteils an Patienten mit relevanten Kopfverletzungen bis auf 58,9% beim >80-Jährigen. Patienten im hohen Lebensalter verweilten signifikant kürzer im Krankenhaus und auf der Intensivstation. Bei vergleichbarem „Injury Severity Score“ (ISS) stieg die Letalität nach Trauma mit dem Alter (18–59 Jahre 13,8%; 60–69 Jahre 24,1%; 70–79 Jahre 35,5%; ≥80 Jahre 43,6%). Der schwer verletzte Patient im höheren Lebensalter unterscheidet sich hinsichtlich Verletzungsart, Therapie und Outcome signifikant vom erwachsenen Normalkollektiv und sollte unter Berücksichtigung dieser Besonderheiten behandelt werden.

Published
2024
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50. Polytrauma

Author

Lehnert, M., Marzi, I., Burchardi, Hilmar, editor, Larsen, Reinhard, editor, Kuhlen, Ralf, editor, Jauch, Karl-Walter, editor, and Schölmerich, Jürgen, editor

Published
2008
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