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Titolo:
Optimal timing for secondary surgery in polytrauma patients: an evaluationof 4314 serious-injury cases
Autore:
Pape, HC; Stalp, M; von Griensven, M; Weinberg, A; Dahlweit, M; Tscherne, H;
Indirizzi:
Hannover Med Sch, Unfallchirurg Klin, D-30625 Hannover, Germany Hannover Med Sch Hannover Germany D-30625 lin, D-30625 Hannover, Germany
Titolo Testata:
CHIRURG
fascicolo: 11, volume: 70, anno: 1999,
pagine: 1287 - 1293
SICI:
0009-4722(199911)70:11<1287:OTFSSI>2.0.ZU;2-W
Fonte:
ISI
Lingua:
GER
Soggetto:
MULTIPLE ORGAN FAILURE; INFLAMMATORY RESPONSE; PLANNED REOPERATION; SEVERE TRAUMA; INTERLEUKIN-6; OPERATIONS; SHEEP;
Keywords:
polytrauma; secondary surgery; timing of surgery; operative trauma; multiple organ failure;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Pape, HC Hannover Med Sch, Unfallchirurg Klin, Carl Neuberg Str 1, D-30625Hannover, Germany Hannover Med Sch Carl Neuberg Str 1 Hannover Germany D-30625 any
Citazione:
H.C. Pape et al., "Optimal timing for secondary surgery in polytrauma patients: an evaluationof 4314 serious-injury cases", CHIRURG, 70(11), 1999, pp. 1287-1293

Abstract

Introduction: It has been argued that secondary operations in multiple trauma patients impose an additional systemic burden, representing an additional risk of organ dysfunction. We investigated whether the timing of a secondary operation of > 3 h duration is related with the development of organ dysfunction. Methods: In a retrospective analysis, 4314 polytrauma patients treated at our institution between January 1975 and January 1999 were investigated. Patients were divided according to the presence (+ MOF) or absence(-MOF) of organ failure (Goris' criteria). Results: In both groups, the injury severity, rescue time, duration and incidence of primary operations were comparable. Secondary surgery in patients who later developed organ failure was significantly more often performed between day 2 and 4, whereas patients without organ failure were usually operated between day 6 and 8 (P < 0.0001). The initial laboratory data in these two groups were comparable. If patients with organ failure were operated on days 6-8, significantly worse initial laboratory data were determined, indicating that these patients were at high risk of developing MOF. Conclusion: 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.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 23:51:32