Damage Control Management in the Polytrauma Patient (eBook)

Peter V. Giannoudis, Hans-Christoph Pape, Andrew B. Peitzman, C. William Schwab (Herausgeber)

eBook Download: PDF

2010 | 2010
XXIV, 463 Seiten
Springer New York (Verlag)
978-0-387-89508-6 (ISBN)

Infos

This guide to damage control surgery focuses on the decision-making process for managing polytrauma. Orthopedists, trauma surgeons, and emergency medicine physicians will learn how to effectively coordinate efforts. The book presents an overview of the damage control concept and the epidemiology of polytrauma injuries. Immunological changes, cascade reactions, and patient selection are discussed. Indications for life-saving procedures, damage control for truncal injuries, and damage control for extremities and pelvic fractures are outlined as well. The text also covers vascular injuries and secondary definitive procedures.

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Orthopedic trauma is largely limited to the stabilization and subsequent surgical management of fractures and dislocations, with most patients presenting to their local emergency departments with isolated injuries. Modern techniques and implants have made outcomes for these injuries more predictable. Intramedullary nailing, for example, has become standard treatment for a displaced fracture of the femoral shaft. These conditions can be managed by the majority of general ort- pedists being trained today. Interestingly, they most likely do not even understand or remember that this treatment evolved from the management of the polytrau- tized patient with fractures. The polytraumatized patient is, of course, a completely different matter. For many years, the only experience with these types of injuries was in casualties sustained by combatants during armed conflicts. Basic concepts such as anest- sia, blood transfusions, intravenous therapy, wound management, and even the development of nursing and the modern hospital were all learned and founded in armed conflicts such as the Crimean War, the Boer War, and World War I. The Second World War saw improvements in the management of both abdominal and extremity wounds, and this was further refined in the Korean and Vietnam Conflicts. These, however, were limited to saving lives and limbs that benefited from very basic care. Understanding even the most rudimentary physiological concepts now taken for granted eluded us, and this showed how limited kno- edge was at that time.

Inhalt

Foreword 6
Foreword 9
Preface 11
Contents 12
Contributors 15
Epidemiology and Pathophysiology 21
The Damage Control Approach 22
Epidemiology of Polytrauma 31
Pathogenetic Changes: Isolated Extremity Trauma and Polytrauma 42
Pathogenetic Changes: Secondary Abdominal Compartment Syndrome 62
Impact of Head and Chest Trauma on General Condition 69
Patient Selection: Orthopedic Approach in Isolated Injuries 84
Patient Selection: Orthopedic Approach in Polytrauma 98
Phases of Damage Control 114
Phase 0: Damage Control Resuscitation in the Pre- hospital and Emergency Department Settings 115
Phase I: Abbreviated Surgery 136
Phase II: The ICU Phase of Damage Control: Managing the Patient from Door to Door 184
Phase III: Second Operation Repair of All Injuries General and Orthopedics 222
Orthopedics 239
Phase IV: Late Reconstruction Abdominal Wall Closure: Staged Management Technique 249
Phase IV: Late Reconstruction: Reconstruction of Posttraumatic Soft Tissue Defects 258
The Role of Interventional Radiology 273
Special Aspects of Damage Control 285
Head Injuries in Polytrauma Patients 286
Spinal Injuries in Polytrauma Patients 297
Pelvic Fractures in Polytrauma Patients 304
Vascular Injuries in Polytrauma Patients 320
Pediatric Trauma and Polytrauma Pediatric Patients 335
Damage Control in Elderly Polytrauma Patients 361
Mass Casualties: Military and Civilian 370
A Civilian Perspective 389
Complications and Outcomes 405
Complications and Outcomes: Abdominal, General, and Extremity Complications 406
Critical Decision Points in Managing the Open Abdomen 425
Functional Long-Term Outcomes in Polytrauma Patients with Orthopedic Injuries 439
Index 452

Produkt-Details

• Erscheint lt. Verlag: 12.8.2010
• Zusatzinfo: XXIV, 463 p.
• Verlagsort: New York
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe
• Themenwelt: Medizinische Fachgebiete ► Chirurgie ► Unfallchirurgie / Orthopädie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Intensivmedizin
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Notfallmedizin
• Schlagworte: Abdominal Wall • complication • complications • Emergency • Fracture • general surgery • Multiple • Multitrauma • orthopaedics • Orthopedics • Polytrauma • Radiology • Surgery • Trauma • trauma surgery
• ISBN-10: 0-387-89508-6 / 0387895086
• ISBN-13: 978-0-387-89508-6 / 9780387895086