Clinical Management and Challenges in Polytrauma

• Other Authors: Pfeifer, Roman (Editor)
• Format: Electronic Book Chapter
• Language: English
• Published: Basel 2022
• Subjects: Medicine; pelvic ring fracture; PCCD; position; associated injuries; geriatric trauma; scoring; polytrauma; ISS; AIS; geriatric patients; orthogeriatric; E-bike injuries; outcome; injury pattern comparison; traumatic injury; reactive oxygen species; phagocytosis; CD14; CD16; CD62L; fMLP; PMA; emergency surgery; trauma team competence; trauma system; life-saving intervention; trauma; non-invasive external pelvic stabilizers; bleeding; pelvic fractures; post mortem analysis; biomechanical force; pneumatic pelvic sling VBM®; T-POD®; cloth sling; SAM Sling®; trauma victims; prehospital death; Injury Severity Score (ISS); hemorrhage; shock; resuscitation; coagulopathy; oxygen transport; endotheliopathy; microcirculation; macrocirculation; orthopaedic trauma; nutritional deficiencies; vitamins; lower extremity; wound complications; nutrition wound healing; platelets; immune system; posttraumatic organ failure; posttraumatic lung dysfunction; posttraumatic hyperinflammation; I-FABP; biomarker; intestinal damage; hemorrhagic shock; major trauma
• Online Access: DOAB: download the publication; DOAB: description of the publication

Trauma is still a leading cause of death in patients below 40 years of age. Clinical management of severely injured patients is challenging in all phases of treatment during the clinical course. Numerous factors, such as injury severity, injury pattern, patient characteristics and trauma system, affect the decision-making process in our patients. After the successful initial management of an unstable multiply injured patient, secondary definitive surgeries and reconstructions may have a risk for further systemic complications and the deterioration of the patient's physiology. A "Safe Definitive Surgery" (SDS) concept considers the dynamics of the clinical course (prehospital, operations, complications, etc.) and the patient's physiology. Due to the repeated re-evaluation and assessment of the patient's clinical course, dynamics and adaptation of the treatment strategy, the safe management of polytraumatized patients is possible. Many unanswered questions still exist and need to be addressed in future studies: Which patients profit by the damage control strategy and which do not? When is it best to start with the definitive fixation of fractures in multiply injured patients? How can one improve the quality of life in polytraumatized patients? What are the strategies in elderly severely injured patients? With this Special Issue, we would like to stimulate research in the field of polytrauma in order to shed light on the above-mentioned questions