Postoperative complications in trauma surgery

Josten, Christoph; Schmidt, Christian

doi:10.1007/s00104-009-1691-2

Cited by 9 publications

(4 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most serious limitation of our study refers to the study design as a cross-sectional study which does not allow any conclusion whether DWH originated from nutritional deficiency or not. A further limitation refers to the high prevalence of vascular diseases, diabetes mellitus and wound infections (Table 4), which are known risk factors for DWH [1]. Hence, effects on WH from these classic risk factors cannot be ruled out.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Extracellular micronutrient levels and pro-/antioxidant status in trauma patients with wound healing disorders: results of a cross-sectional study

Blaß

Goost

Burger

et al. 2013

Nutr J

View full text Add to dashboard Cite

BackgroundDisorders in wound healing (DWH) are common in trauma patients, the reasons being not completely understood. Inadequate nutritional status may favor DWH, partly by means of oxidative stress. Reliable data, however, are lacking. This study should investigate the status of extracellular micronutrients in patients with DWH within routine setting.MethodsWithin a cross-sectional study, the plasma/serum status of several micronutrients (retinol, ascorbic acid, 25-hydroxycholecalciferol, α-tocopherol, β-carotene, selenium, and zinc) were determined in 44 trauma patients with DWH in addition to selected proteins (albumin, prealbumin, and C-reactive protein; CRP) and markers of pro-/antioxidant balance (antioxidant capacity, peroxides, and malondialdehyde). Values were compared to reference values to calculate the prevalence for biochemical deficiency. Correlations between CRP, albumin and prealbumin, and selected micronutrients were analyzed by Pearson’s test. Statistical significance was set at P < 0.05.ResultsMean concentrations of ascorbic acid (23.1 ± 15.9 μmol/L), 25-hydroxycholecalciferol (46.2±30.6 nmol/L), β-carotene (0.6 ± 0.4 μmol/L), selenium (0.79±0.19 μmol/L), and prealbumin (24.8 ± 8.2 mg/dL) were relatively low. Most patients showed levels of ascorbic acid (<28 μmol/L; 64%), 25-hydroxycholecalciferol (<50 μmol/L; 59%), selenium (≤ 94 μmol/L; 71%) and β-carotene (<0.9 μmol/L; 86%) below the reference range. Albumin and prealbumin were in the lower normal range and CRP was mostly above the reference range. Plasma antioxidant capacity was decreased, whereas peroxides and malondialdehyde were increased compared to normal values. Inverse correlations were found between CRP and albumin (P < 0.05) and between CRP and prealbumin (P < 0.01). Retinol (P < 0.001), ascorbic acid (P < 0.01), zinc (P < 0.001), and selenium (P < 0.001) were negatively correlated with CRP.ConclusionsTrauma patients with DWH frequently suffer from protein malnutrition and reduced plasma concentrations of several micronutrients probably due to inflammation, increased requirement, and oxidative burden. Thus, adequate nutritional measures are strongly recommended to trauma patients.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Disorders in wound healing (DWH) are frequently observed post-surgically in patients with vascular diseases and soft tissue trauma [1]. DWH are associated with a prolonged hospital stay and essentially contribute to high morbidity and mortality [2].…”

Section: Introductionmentioning

confidence: 99%

Extracellular micronutrient levels and pro-/antioxidant status in trauma patients with wound healing disorders: results of a cross-sectional study

Blaß

Goost

Burger

et al. 2013

Nutr J

View full text Add to dashboard Cite

show abstract

“…These complications have been associated with a negative impact on long-term functional capacity and quality of life [6]. Many complications are potentially avoidable and quality improvement strategies aimed at reducing them have been shown to have a positive impact on patient outcome and resource utilization [7,8]. …”

Section: Introductionmentioning

confidence: 99%

Complication rates as a trauma care performance indicator: a systematic review

2012

View full text Add to dashboard Cite

IntroductionInformation on complication rates is essential to trauma quality improvement efforts. However, it is unclear which complications are the most clinically relevant. The objective of this study was to evaluate whether there is consensus on the complications that should be used to evaluate the performance of acute care trauma hospitals.MethodsWe searched the Medline, EMBASE, Cochrane Central, CINAHL, BIOSIS, TRIP and ProQuest databases and included studies using at least one nonfatal outcome to evaluate the performance of acute care trauma hospitals. Data were extracted in duplicate using a piloted electronic data abstraction form. Consensus was considered to be reached if a specific complication was used in ≥ 70% of studies (strong recommendation) or in ≥ 50% of studies (weak recommendation).ResultsOf 14,521 citations identified, 22 were eligible for inclusion. We observed important heterogeneity in the complications used to evaluate trauma care. Seventy-nine specific complications were identified but none were used in ≥ 70% of studies and only three (pulmonary embolism, deep vein thrombosis, and pneumonia) were used in ≥ 50% of studies. Only one study provided evidence for the clinical relevance of complications used and only five studies (23%) were considered of high methodological quality.ConclusionBased on the results of this review, we can make a weak recommendation on three complications that should be used to evaluate acute care trauma hospitals; pulmonary embolism, deep vein thrombosis, and pneumonia. However, considering the observed disparity in definitions, the lack of clinical justification for the complications used, and the low methodological quality of studies, further research is needed to develop a valid and reliable performance indicator based on complications that can be used to improve the quality and efficiency of trauma care.

show abstract

“…Seitdem haben sich die winkelstabilen Systeme bei vielversprechenden Studienergebnissen [15][16][17][18][19][20][21][22] flächendeckend durchgesetzt. Nach Einführung der Plattenfixateure ist zu den bekannten implantatbezogenen Versagensmustern (Plattenbruch, Refraktur an der Plattenspitze, Schraubenausriss [23,24]) eine neue Form des Implantatversagens hinzugekommen: der Ausriss des intakten Platten-Schrauben-Konstrukts aus dem Knochen. Dies kann auftreten, wenn die Festigkeit der Metallkonstruktion die Festigkeit der Schrauben-Knochen-Verbindung übersteigt.…”

unclassified