Stinner Daniel J, Edwards Dafydd
Royal School of Mines, Centre for Blast Injury Studies, Imperial College London, Prince Consort Road, Kensington, London SW7 2BP, UK; US Army Institute of Surgical Research, San Antonio, TX, USA.
Royal School of Mines, Centre for Blast Injury Studies, Imperial College London, Prince Consort Road, Kensington, London SW7 2BP, UK; Royal Centre for Defence Medicine, Birmingham, UK.
Surg Clin North Am. 2017 Oct;97(5):1119-1131. doi: 10.1016/j.suc.2017.06.005.
Musculoskeletal injuries cause a significant burden to society and can have a considerable impact on patient morbidity and mortality. It was initially thought that these patients were too sick to undergo surgery and later believed that they were too sick not to undergo surgery. The pendulum has subsequently swung back and forth between damage control orthopedics and early total care for polytrauma patients with extremity injuries and has settled on providing early appropriate care (EAC). The decision-making process in providing EAC is reviewed in an effort to optimize patient outcomes following severe extremity trauma.
肌肉骨骼损伤给社会带来了沉重负担，并且会对患者的发病率和死亡率产生重大影响。最初人们认为这些患者病情太重无法接受手术，后来又认为他们病情太重不能不接受手术。随后，对于伴有肢体损伤的多发伤患者，在损伤控制骨科和早期全面治疗之间摇摆不定，最终确定为提供早期适当治疗（EAC）。本文回顾了提供EAC的决策过程，以期优化严重肢体创伤后的患者治疗效果。
