Horst Klemens, Hamsen Uwe, Volmerig Jan, Benstöm Carina, Marx Gernot, Hildebrand Frank
Klinik für Orthopädie, Unfall- und Wiederherstellungschirurgie, Uniklinik RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Deutschland.
Chirurgische Klinik, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland.
Unfallchirurgie (Heidelb). 2025 Sep 5. doi: 10.1007/s00113-025-01626-2.
The treatment of polytraumatized patients is challenging. Intensive efforts and interdisciplinary teamwork have improved survival rates of severely injured patients over the last decades. High quality guideline recommendations focusing on the prehospital setting, emergency room management and also the initial surgical phase have been published and are frequently updated. The current manuscript is part of new guidelines on an S3 level that focuses on treatment of polytraumatized patients who were transferred to the intensive care unit after initial emergency treatment. These patients have special needs, especially with respect to monitoring, pain management, ventilation strategy, nutrition etc. and most often require definitive surgical stabilization of injuries to the thorax, abdomen, pelvis and extremities. This article summarizes the current literature and gives recommendations with respect to early definitive treatment of patients with multiple trauma and particularly with a view to the best possible timing of the definitive treatment.
多发伤患者的治疗具有挑战性。在过去几十年中，通过 intensive efforts 和跨学科团队合作，严重受伤患者的存活率有所提高。针对院前环境、急诊室管理以及初始手术阶段的高质量指南建议已经发布并经常更新。当前的手稿是 S3 级新指南的一部分，该指南侧重于初始紧急治疗后转入重症监护病房的多发伤患者的治疗。这些患者有特殊需求，特别是在监测、疼痛管理、通气策略、营养等方面，并且大多数情况下需要对胸部、腹部、骨盆和四肢的损伤进行确定性手术稳定。本文总结了当前的文献，并就多发伤患者的早期确定性治疗，特别是关于确定性治疗的最佳时机给出了建议。
