Jokuszies Andreas, Martyniak L, Dastagir K, Weyand B, Vogt P M, Krezdorn N
Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Replantationszentrum, Schwerbrandverletztenzentrum, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Unfallchirurg. 2021 Oct;124(10):817-822. doi: 10.1007/s00113-021-01053-z. Epub 2021 Jul 20.
Polytraumatized burn patients represent a rare patient collective and necessitate an individualized treatment concept due to the particular combination of injuries.
Against the background of this special injury pattern, especially with deep burns overlying the fracture zone, the question of a specific and interdisciplinary treatment algorithm arises.
This article is based on a PubMed database search and experiences of a trauma center for severely injured burn patients at a university hospital, with presentation of the special therapeutic requirements and goals exemplified by a case report.
The evaluation of the literature search and own treatment results comes to the conclusion that the rate and extent of amputations and infections can be reduced by an early and interdisciplinary involvement of the plastic surgeon by early combined fracture stabilization, excision of necrotic tissue and immediate skin grafting. Furthermore, plastic reconstructive procedures enable a functional and esthetic reconstruction with optimized prosthesis fitting.
Polytraumatized severely burned patients necessitate an interdisciplinary treatment approach, whereby preservation of length, functionality and esthetic appearance of the affected extremities and concurrent avoidance of bone and soft tissue infections have utmost priority.
多发伤烧伤患者是一个特殊的患者群体，由于损伤的特殊组合，需要个性化的治疗方案。
在这种特殊损伤模式的背景下，尤其是骨折部位有深度烧伤时，就出现了特定的跨学科治疗方案的问题。
本文基于对PubMed数据库的检索以及一所大学医院创伤中心对重度烧伤患者的治疗经验，通过病例报告举例说明特殊的治疗要求和目标。
对文献检索和自身治疗结果的评估得出结论，通过整形外科医生早期跨学科介入，早期联合骨折固定、切除坏死组织并立即植皮，可以降低截肢率和感染率及感染范围。此外，整形重建手术能够实现功能和美学重建，并优化假肢适配。
多发伤重度烧伤患者需要跨学科治疗方法，其中，保留患肢的长度、功能和美观外形以及同时避免骨和软组织感染是重中之重。
