Akademie der Unfallchirurgie (AUC), Luisenstrasse 58/59, 10117, Berlin, Germany.
Clin Orthop Relat Res. 2013 Sep;471(9):2912-23. doi: 10.1007/s11999-013-2967-x.
Development of trauma systems is a demanding process. The United States and Germany both have sophisticated trauma systems. This manuscript is a summary of political, economic, and medical changes that have led to the development of both trauma systems and the current high-quality standards.
QUESTIONS/PURPOSES: We specifically asked three questions: (1) What tasks are involved in developing a modern trauma system? (2) What is the approach to achieve this task? (3) Do these systems work?
We conducted a systematic review of relevant articles by searching electronic databases (PubMed, Embase, Cochrane library) using the following search terms: "trauma system", "polytrauma", "trauma networks", and "trauma registry". Of 2573 retrieved manuscripts, the authors made a personal selection of studies. A personal study selection from our experiences was added when their contribution to the topic was judged important.
Worldwide, similar tasks concerning trauma care have to be addressed. In most societies, traffic accidents and firearm-related injuries contribute to a high number of trauma victims. The German approach has been to decrease the number of accidents through injury prevention and to provide better care by establishing an emergency medical system. For in-hospital treatment, clinical care has constantly improved and a close interaction with members from the American Association for the Surgery of Trauma and the Orthopaedic Trauma Association has helped a great deal to achieve these improvements. The German healthcare system was developed as a powerful healthcare tool covering patients from injury to rehabilitation. In addition, trauma and injury research has been strengthened to deal with various questions of trauma care.
Organized injury prevention programs and systematized professional patient care can address the issues associated with the global burden of trauma. These trauma systems require constant monitoring and improvement.
创伤体系的发展是一个艰巨的过程。美国和德国都有完善的创伤体系。本文总结了导致两国创伤体系发展和当前高质量标准形成的政治、经济和医疗方面的变化。
问题/目的：我们特别提出了三个问题：（1）建立现代创伤体系涉及哪些任务？（2）实现这一任务的方法是什么？（3）这些体系是否有效？
我们通过搜索电子数据库（PubMed、Embase、Cochrane 图书馆）使用以下搜索词：“创伤体系”、“多发伤”、“创伤网络”和“创伤登记”，对相关文章进行了系统综述。在 2573 篇检索到的文献中，作者对研究进行了个人选择。当个人研究被判断对主题有重要贡献时，也会添加个人经验。
全球范围内，类似的创伤护理任务都需要解决。在大多数社会中，交通事故和与枪支有关的伤害导致大量创伤患者。德国的方法是通过预防事故来减少事故数量，并通过建立紧急医疗系统来提供更好的护理。在院内治疗方面，临床护理不断得到改善，与美国创伤外科学会和矫形创伤协会的成员密切合作，对实现这些改善有很大帮助。德国医疗保健系统是作为一个强大的医疗工具开发的，涵盖了从受伤到康复的患者。此外，创伤和伤害研究也得到了加强，以应对各种创伤护理问题。
有组织的预防伤害计划和系统的专业患者护理可以解决与全球创伤负担相关的问题。这些创伤体系需要不断监测和改进。
