[S3 guideline on treatment of polytrauma/severe injuries. Initial surgical phase: significance--possibilities--difficulties?].

There is no universal, generally established strategy for polytrauma management in Germany until now. The new S3 guideline on polytrauma patient care is the first high-level evidence-based compendium consented to by all major medical societies in Germany. This report emphasises all new guideline recommendations concerning the early operative care of multiply injured patients. With regard to the available evidence in the literature this report shows that the assessment of key recommendations is often difficult due to a lack of data. For guideline explanations with the highest grade of recommendation however it can be assumed that there is no alternative and that these will be implemented nationwide. This study also shows that the absolute and relative number of recommendations and the corresponding grade of recommendation do not correlate with the frequency and severity of injuries in an average polytrauma patient. It will now become a major challenge in German trauma care to incorporate all S3 guideline recommendations into the local treatment algorithms. Regional trauma networks could play a key role in this crucial task.