Felix Karl Ludwig Klingebiel (Zurich / CH), Oliver Straehle (Zurich / CH), Yannik Kalbas (Zurich / CH), Michel Paul Johan Teuben (Zurich / CH), Sascha Halvachizadeh (Zurich / CH), Hans-Christoph Pape (Zurich / CH), Roman Pfeifer (Zurich / CH)
Abstract text (incl. references and figure legends)
Introduction
It is known that the amount and timing as well as the surgical procedure itself play a crucial role in polytraumatized patients. Still there is little knowledge, which factors should be considered most when it comes to evaluating the damage dealt to the patient by surgery. In addition, there is little evidence which body regions and operational procedures are associated with a higher surgical impact. The aim of this study was to approximate a definition of the Surgical Load.
Material & Methods
A standardized questionnaire was developed by experts from SICOT-Trauma committee. Questions included relevance and composition of the Surgical Load, operational staging criteria and stratification of operation procedures in different anatomic region. The questionnaire was completed online by members of the SICOT society.
Results
196 trauma surgeons from 63 countries with a median of 13 years work experience in polytrauma care participated between 06/27/22 and 08/16/22. Surgical Load (SL) overall was considered as very important (77%; important: 20.9%). Intraoperative blood loss (43.2%) and soft tissue damage (29.6%) were chosen as the most relevant factors. Staging procedures were mostly planned according to body region (56.1%), followed by bleeding risk (18.9%) and fracture complexity (9.2%). Open surgical procedures of the pelvis (SL=3.55), spine (SL=3.36), long bones (SL humerus=3.01; SL femur=3.33) and knee (SL=3.24) or elbow joint (SL=3.12) were ranked highest in their Surgical Load. Percutaneous or intramedullary procedures as well as more distal fractures were constantly ranked lower.
Conclusions
Operational staging in polytraumatized patients might benefit from taking the Surgical Load into consideration. Further studies are needed to determine the role of the Surgical Load in planning surgical care of polytrauma patients.
References
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