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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 6/2011

01-12-2011 | Review Article

Physiological assessment of the polytrauma patient: initial and secondary surgeries

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

Published in: European Journal of Trauma and Emergency Surgery | Issue 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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Metadata
Title
Physiological assessment of the polytrauma patient: initial and secondary surgeries
Authors
N. Enninghorst
R. Peralta
O. Yoshino
R. Pfeifer
H. C. Pape
B. M. Hardy
D. C. Dewar
Z. J. Balogh
Publication date
01-12-2011
Publisher
Springer-Verlag
Published in
European Journal of Trauma and Emergency Surgery / Issue 6/2011
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-011-0161-y

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