Library

feed icon rss

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Der Unfallchirurg 103 (2000), S. 342-347 
    ISSN: 1433-044X
    Keywords: Schlüsselwörter Komplexe Handverletzung ; Strategie ; Algorithmus ; Key words Complex hand injuries ; Strategy ; Algorithm
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract There are no clear definitions of serious or complex hand injuries in the literature. Multistructural injuries involving a vital risk to the affected part of the body part are usually classified as complex. The quality of the reconstruction, based on sound management principles, determines the aesthetic and functional outcome for the patient. The strategies basically consist of: Careful radical dèbridement, thorough analysis of the defect and evaluation of lost functions, injury classification, Patient oriented reconstructive procedures, careful and realistic explanation of perspectives and risks to the patient. Following these principles will most likely achieve the planned objectives of treatment, such as, best possible restoration of form and function, cost-effective therapy, and early professional and social reintegration. Algorithmic approaches are an important aid in the clinical approach to these kinds of problems, making it possible to reach clear reproducible decisions that are amenable to standardization. Despite all individual decisions necessary to achieve optimal care, this standard theoretical framework will be able to improve the quality of care.
    Notes: Zusammenfassung In der Literatur findet sich keine klare Definition für schwere oder komplexe Handverletzungen. Im internationalen Konsens werden multistrukturelle Verletzungen mit Gefährdung des betroffenen Körperteils als komplex eingestuft. Die Qualität der Rekonstruktion und der Weiterbehandlung bestimmen das ästhetische und funktionelle Endergebnis für den Patienten. Eine optimale Lösung basiert jedoch immer auf einer sinnvollen strategischen Planung, die aus folgenden Schritten bestehen sollte: Ein sorgfältiges radikales Débridement; eine gründliche Analyse des resezierenden Defekts und der daraus entstehenden Funktionsausfälle; einer wann immer möglichen einzeitigen Rekonstruktion bei gleichzeitiger vorausschauender Planung für eventuelle Sekundäreingriffe; einer sorgfältigen Patientenaufklärung, die realistisch die Perspektiven und möglichen Risiken des operativen Eingriffs darstellt. Mit Einhaltung dieser strategischen Grundsätze lassen sich die Therapieziele – Erhaltung der Extremität, bestmögliche Wiederherstellung von Form und Funktion, frühe berufliche und soziale Reintegration und die Vermeidung von Spätfolgen – am ehesten realisieren. Eine wichtige Hilfe in der klinischen Situation kann die algorithmische Problemlösung darstellen, die klare, standardisierbare nachvollziehbare Entscheidungen vorgibt. Ohne die Flexibilität des Chirurgen einzuschränken, ist so doch ein theoretisches Standardgerüst der Versorgungsstrategie gegeben, mit dem grundsätzlich die Versorgungsqualität verbessert werden kann.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
  • 2
    Electronic Resource
    Electronic Resource
    Springer
    European journal of plastic surgery 23 (2000), S. 28-31 
    ISSN: 1435-0130
    Keywords: Key words Burns ; Acute-phase proteins ; Inflammatory reaction ; Trauma response ; Immune system
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Transport proteins and acute-phase proteins, including complement factors C3 and C4, immunoglobulin A (IgA), IgM, albumin (ALB), prealbumin (PAB), transferrin (TRF), ceruloplasmin (CER), haptoglobin (HAG), and alpha antitrypsin (AAT), were examined in 29 patients with severe burns with a total burn surface area (TBSA) ranging from 30% to 97% (mean, 50.03%±21.16%). Samples from each patient were obtained at days 2, 7, 14, and 21 postburn and were analyzed using a 3M 300 special automatic analyzing system (Sanofi, France). A population of normal individuals served as controls. Statistical analyses were performed using multivariate and regression analyses. The postburn values of C3, C4, PAB, ALB, TRF, and CER were significantly lower compared to controls (P〉0.01). Slow postburn recovery was observed for C3 and C4, which was negatively correlated with burn severity. TAF, TAB, and ALB values decreased significantly within the first week postburn (P〈0.01); TAF, PAB, and ALB values demonstrated a steady recovery between days 14 and 21 postburn. The recovery was negatively correlated to the severity of the burns. IgA and IgM markedly decreased after 2 days postburn (P〈0.01). After the initial decrease, the levels of IgM slowly increased, whereas the levels of IgA remained depressed for the first postburn week. The levels of AAT rose significantly throughout the entire study period and were positively correlated with the severity of the burns (P〈0.01). This study demonstrates a pattern of certain reactive/acute-phase proteins in the postburn period. It can be concluded that severe burns directly affect the production of serum levels of acute-phase proteins, thereby impairing important physiological functions such as the immune system, protein transportation, metabolism, and repair processes.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...