Severely injured patients: modern management strategies

EFORT Open Reviews

article

Vasileios P Giannoudis¹  Paul Rodham¹  Peter V Giannoudis¹  Nikolaos K Kanakaris¹ 

[1] Major Trauma Centre, Leeds Teaching Hospitals NHS Trust;Academic Department of Trauma and Orthopaedics, School of Medicine, University of Leeds

关键词: major trauma;    polytrauma;    management;    damage control;    early appropriate care;    review;   

DOI  :  10.1530/EOR-23-0053

学科分类：神经科学

来源: The British Editorial Society of Bone & Joint Surgery

【 摘 要 】

Management of severely injured patients remains a challenge, characterised by a number of advances in clinical practice over the last decades. This evolution refers to all different phases of patient treatment from prehospital to the long-term rehabilitation of the survivors. The spectrum of injuries and their severity is quite extensive, which dictates a clear understanding of the existing nomenclature. What is defined nowadays as polytrauma or major trauma, together with other essential terms used in the orthopaedic trauma literature, is described in this instructional review. Furthermore, an analysis of contemporary management strategies (early total care (ETG), damage control orthopaedics (DCO), early appropriate care (EAC), safe definitive surgery (SDS), prompt individualised safe management (PRISM) and musculoskeletal temporary surgery (MuST)) advocated over the last two decades is presented.A focused description of new methods and techniques that have been introduced in clinical practice recently in all different phases of trauma management will also be presented. As the understanding of trauma pathophysiology and subsequently the clinical practice continuously evolves, as the means of scientific interaction and exchange of knowledge improves dramatically, observing different standards between different healthcare systems and geographic regions remains problematic. Positive impact on the survivorship rates and decrease in disability can only be achieved with teamwork training on technical and non-technical skills, as well as with efficient use of the available resources.

【 授权许可】

CC BY|CC BY-NC|CC BY-NC-ND