The Benefit of Benzodiazepine Reduction: Improving Sedation in Surgical Intensive Care.

Aims: Sedation, as it is often required in critical care, is associated with immobilization, prolonged ventilation, and increased morbidity. Most sedation protocols are based on benzodiazepines. The presented study analyzes the benefit of benzodiazepine-free sedation.

TraumaNetzwerk DGU(®): optimizing patient flow and management.

Purpose: Caring for severely injured trauma patients is challenging for all medical professionals involved both in the preclinical and in the clinical course of treatment. While the overall quality of care in Germany is high there still are significant regional differences remaining. Reasons are geographical and infrastructural differences as well as variations in personnel and equipment of the hospitals.

Implementation of a nationwide trauma network for the care of severely injured patients.

Background: Regional differences in the care of severely injured patients remain problematic in industrial countries.

Methods: In 2006, the German Society for Trauma Surgery initiated the foundation of regional networks between trauma centers in a TraumaNetwork (TNW). The TNW consisted of five major elements as follows: (a) a whitebook on the treatment of severely injured patients; (b) evidence-based guidelines (S3); (c) local audits; (d) contracts of interhospital cooperation among all participating hospitals; and (e) TraumaRegister documentation.

Less invasive polyaxial locking plate fixation in periprosthetic and peri-implant fractures of the femur--a prospective study of 41 patients.

Background: A great variety of methods for the stabilisation of periprosthetic fractures around total hip (THA) or total knee arthroplasty (TKA) have been described. We present the data of our experience in combining a polyaxial, anatomical locking plate with a standardised less invasive technique in the treatment of periprosthetic and peri-implant (femoral nail) femur fractures in this prospective study.

Patients And Methods: A consecutive series of 41 patients (33 women; age 79.

The two-incision, minimally invasive approach in the treatment of acetabular fractures.

Objectives: To present a novel two-incision minimally invasive (TIMI) method for the treatment of anterior acetabular fractures.

Design: Prospective consecutive case series.

Setting: Level I University Trauma Centre.

Minimally invasive polyaxial locking plate fixation of proximal humeral fractures: a prospective study.

Background: The surgical treatment for displaced humeral head fractures overlooks a broad variety of surgical techniques and implant systems. A standard operative procedure has not yet been established. In this article, we report our experience with a second-generation locking plate for the humeral head fracture that is applied in a standardized nine-step minimally invasive surgical technique (MIS).

Monoaxial versus polyaxial locking systems: a biomechanical analysis of different locking systems for the fixation of proximal humeral fractures.

Objective: The development of locking plate systems has led to polyaxial screws and new plate designs. This study compares monoaxial head locking screws (PHILOS© by Synthes) and a new generation of polyaxial locking screws (NCB-LE© by Zimmer) with respect to biomechanical stability.

Methods: On nine pairs of randomised formalin fixed humerus specimens, standardised osteotomies and osteosyntheses with nine monoaxial (group A) und nine polyaxial (group B) plate/screw systems were performed.

Damage control orthopedics in patients with multiple injuries is effective, time saving, and safe.

Background: Although early fracture fixation is expedient in patients with multiple injuries, early total care (ETC) may be associated with posttraumatic systemic complications. This study was conducted to prospectively evaluate the concept of damage control by immediate external fracture fixation (damage control orthopedics [DCO]) and consecutive conversion osteosynthesis with regard to time savings, effectiveness, and safety.

Methods: In a prospective controlled trial, a cohort of 1,070 patients with an Injury Severity Score (ISS) of 20.

Free abdominal fluid on ultrasound in unstable pelvic ring fracture: is laparotomy always necessary?

Background: In unstable pelvic ring fractures free abdominal fluid on ultrasound (US) may be caused by retroperitoneal hematoma that passes into the abdominal cavity or by an additional intraabdominal lesion. In this study a clinical pathway for the therapy of potentially combined lesions was analyzed.

Patients And Methods: All patients treated in the ED for severe trauma underwent basic sonographical and radiologic diagnostics within 15 minutes.

A multidisciplinary quality management system for the early treatment of severely injured patients: implementation and results in two trauma centers.

Objective: The impact of a multidisciplinary quality management system (MQMS) on the early treatment of severely injured patients was tested.

Design And Setting: Prospective clinical study in two level 1 trauma centers.

Methods And Materials: MQMS comprised a protocol for documentation, 20 assessment criteria, and the judgement of data by a quality circle.

Prehospital intubation in severe thoracic trauma without respiratory insufficiency: a matched-pair analysis based on the Trauma Registry of the German Trauma Society.

Objective: On the basis of the data of a multicenter study, the impact of prehospital intubation and ventilation in the therapy of severe thoracic trauma without manifest respiratory insufficiency was analyzed.

Methods: Data were collected prospectively in the Trauma Registry of the German Trauma Society. In a matched-pair analysis, patients with severe thoracic trauma (Abbreviated Injury Scale score of 4) with and without prehospital intubation were compared.