Scientific Backgrounds for the Timing of Acute Care Surgery

Abstract

The correct timing of urgent surgery in the field of orthopedic and trauma surgery is under constant discussion. The authors of this review like to present a scientific based recommendation for the timing of acute care surgery using the TACS-classification for the description of urgency. The timing and priority of the indicated procedure is deduced only from the expected mortality and disability caused by a potential delay. A proposal for a nomenclature is given to be integrated in the clinical practice and to be completed.

Key words

emergency surgery - timing of acute care surgery

• References/Literatur

• 1 Iselin M. Aufgeschobene Dringlichkeit bei der Wundversorgung. Langenbecks Arch Klin Chir Ver Dtsch Z Chir 1962; 301: 91-96
• 2 National Confidential Enquiry into Patient Outcome and Death (NCEPOD). The NCEPOD Classification of Intervention. Im Internet: https://www.ncepod.org.uk/classification.html Stand: 19.03.2019
• 3 Kluger Y, Ben-Ishay O, Sartelli M. et al. World society of emergency surgery study group initiative on Timing of Acute Care Surgery classification (TACS). World J Emerg Surg 2013; 8: 17
• 4 Landtag Baden-Württemberg. Gesetz über den Rettungsdienst (Rettungsdienstgesetz – RDG) in der Fassung vom 8. Februar 2010. Im Internet: http://www.landesrecht-bw.de/jportal/?quelle=jlink&query=RettDG+BW&psml=bsbawueprod.psml&max=true&aiz=true Stand: 04.03.2019
• 5 Landtag Hessen. Hessisches Rettungsdienstgesetz (HRDG) vom 16. Dezember 2010. Im Internet: https://soziales.hessen.de/sites/default/files/media/hsm/hrdg_2018.pdf Stand: 04.03.2019
• 6 Landtag Nordrhein-Westfalen. Krankenhausgesetz des Landes Nordrhein-Westfalen (KHG NRW) vom 16. Dezember 1998. Im Internet: https://recht.nrw.de/lmi/owa/br_vbl_detail_text?anw_nr=6&vd_id=2175&vd_back=N696 Stand: 04.03.2019
• 7 Centre for Evidence-Based Medicine. Oxford Centre for Evidence-based Medicine – Levels for Evidence (March 2009). Im Internet: https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009 Stand. 19.03.2019
• 8 Deutsche Gesellschaft für Orthopädie und Unfallchirurgie e.V.. Hrsg. S3-Leitlinie Polytrauma/Schwerverletzten-Behandlung; Stand 07/2016. AWMF-Register-Nr.: 012–019. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/012-019l_S3_Polytrauma_Schwerverletzten-Behandlung_2017-08.pdf Stand: 04.03.2019
• 9 Huber-Wagner S, Lefering R, Qvick LM. et al. Effect of whole-body CT during trauma resuscitation on survival: a retrospective, multicentre study. Lancet 2009; 373: 1455-1461
• 10 Huber-Wagner S, Biberthaler P, Häberle S. et al. Whole-body CT in haemodynamically unstable severely injured patients–a retrospective, multicentre study. PLoS One 2013; 8: e68880
• 11 Glass GE, Pearse MF, Nanchahal J. Improving lower limb salvage following fractures with vascular injury: a systematic review and new management algorithm. J Plast Reconstr Aesthet Surg 2009; 62: 571-579
• 12 Friedrich PL. Die aseptische Versorgung frischer Wunden. Arch Klin Chir 1898; 57: 288-310
• 13 Robson MC, Duke WF, Krizek TJ. Rapid bacterial screening in the treatment of civilian wounds. J Surg Res 1973; 14: 426-430
• 14 Gustilo RB, Anderson JT. Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses. J Bone Joint Surg Am 1976; 58: 453-458
• 15 DeLong jr. WG, Born CT, Wei SY. et al. Aggressive treatment of 119 open fracture wounds. J Trauma 1999; 46: 1049-1054
• 16 Schenker ML, Yannascoli S, Baldwin KD. et al. Does timing to operative debridement affect infectious complications in open long-bone fractures? A systematic review. J Bone Joint Surg Am 2012; 94: 1057-1064
• 17 Prodromidis AD, Charalambous CP. The 6-hour rule for surgical debridement of open tibial fractures: a systematic review and meta-analysis of infection and nonunion rates. J Orthop Trauma 2016; 30: 397-402
• 18 Harley BJ, Beaupre LA, Jones CA. et al. The effect of time to definitive treatment on the rate of nonunion and infection in open fractures. J Orthop Trauma 2002; 16: 484-490
• 19 Fraitzl CR, Flören M, Reichel H. Kniegelenk – Arthrose und Arthritis. Orthopädie und Unfallchirurgie up2date 2008; 3: 155-176
• 20 Lauper N, Davat M, Gjika E. et al. Native septic arthritis is not an immediate surgical emergency. J Infect 2018; 77: 47-53
• 21 Dvorak MF, Noonan VK, Fallah N. et al. The influence of time from injury to surgery on motor recovery and length of hospital stay in acute traumatic spinal cord injury: an observational Canadian cohort study. J Neurotrauma 2015; 32: 645-654
• 22 Fehlings MG, Vaccaro A, Wilson JR. et al. Early versus delayed decompression for traumatic cervical spinal cord injury: results of the Surgical Timing in Acute Spinal Cord Injury Study (STASCIS). PLoS One 2012; 7: e32037
• 23 Du JP, Fan Y, Liu JJ. et al. Decompression for traumatic thoracic/thoracolumbar incomplete spinal cord injury: application of AO spine injury classification system to identify the timing of operation. World Neurosurg 2018; 116: e867-e873
• 24 Sachse D, Bludau F, Obertacke U. [Fractures of the neck of the femur in younger patients (15–50 years old). Systematic literature research on medial fractures of the neck of the femur in young patients]. Unfallchirurg 2010; 113: 69-74
• 25 Todd NV, Dickson RA. Standards of care in cauda equina syndrome. Br J Neurosurg 2016; 30: 518-522
• 26 Srikandarajah N, Wilby M, Clark S. et al. Outcomes reported after surgery for cauda equina syndrome: a systematic literature review. Spine (Phila Pa 1976) 2018; 43: E1005-E1013
• 27 Srikandarajah N, Boissaud-Cooke MA, Clark S. et al. Does early surgical decompression in cauda equina syndrome improve bladder outcome?. Spine (Phila Pa 1976) 2015; 40: 580-583
• 28 Weinstein JN, Lurie JD, Tosteson TD. et al. Surgical versus nonoperative treatment for lumbar disc herniation: four-year results for the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976) 2008; 33: 2789-2800
• 29 Schoenfeld AJ, Bono CM. Does surgical timing influence functional recovery after lumbar discectomy? A systematic review. Clin Orthop Relat Res 2015; 473: 1963-1970
• 30 Petr O, Glodny B, Brawanski K. et al. Immediate versus delayed surgical treatment of lumbar disc herniation for acute motor deficits: the impact of surgical timing on functional outcome. Spine (Phila Pa 1976) 2017;
• 31 Bonnaire F, Weber A. S2e-Leitlinie 012/001: Schenkelhalsfraktur des Erwachsenen. Letztes Bearbeitungsdatum: 09.10.2015. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/012-001l_S2e_Schenkelhalsfraktur_2015-10_01.pdf Stand: 04.03.2019
• 32 Barnes R, Brown JT, Garden RS, Nicoll EA. Subcapital fractures of the femur. A prospective review. J Bone Joint Surg Br 1976; 58: 2-24
• 33 Institut für Qualität und Transparenz im Gesundheitswesen. Hüftgelenknahe Femurfraktur mit osteosynthetischer Versorgung. Im Internet: https://iqtig.org/qs-verfahren/hueftfrak-osteo/ Stand: 12.07.2017
• 34 Gleisberg G, Malek D, Stich AK. et al. Operative Versorgung von Patienten mit einer hüftgelenknahen Femurfraktur: Die bisherigen Maßnahmen der Qualitätssicherung reichen nicht aus. Dezember 2017. GKV-90Prozent. Im Internet: https://www.gkv-90prozent.de/ausgabe/07/autorenbeitrag/07_femurfraktur/07_femurfraktur.html Stand: 19.03.2019
• 35 Geschäftsstelle Qualitätssicherung im Krankenhaus (GeQiK). Modul17/1: Hüftgelenknahe Femurfraktur mit osteosynthetischer Versorgung. Gesamtauswertung 2017, Baden-Württemberg. Im Internet: http://www.geqik.de/fileadmin/Archiv/2017/Jahresauswertungen/2017_17_1_Gesamtauswertung.pdf Stand: 04.03.2019
• 36 Towfigh H, Hierner R, Langer M, Friedel R. Handchirurgie, Prinzipien der Sehnenbehandlung: Beugesehnen. Berlin, Heidelberg: Springer; 2011: 101-138
• 37 Green DP, Hotchkiss RN, Pederson WC. eds. Operative Hand Surgery. 4th ed. Philadelphia: Churchill Livingstone; 1998
• 38 Schädel-Höpfner M, Siebert H. [Operative strategies for hand injuries in multiple trauma. A systematic review of the literature]. Unfallchirurg 2005; 108: 850-857
• 39 Juon BH, Iseli M, Kreutziger J. et al. Treatment of open hand injuries: does timing of surgery matter? A single-centre prospective analysis. J Plast Surg Hand Surg 2014; 48: 330-333
• 40 Angly B, Constantinescu MA, Kreutziger J. et al. Early versus delayed surgical treatment in open hand injuries: a paradigm revisited. World J Surg 2012; 36: 826-829
• 41 Zehtabchi S, Tan A, Yadav K. et al. The impact of wound age on the infection rate of simple lacerations repaired in the emergency department. Injury 2012; 43: 1793-1798
• 42 Barei DP, Nork SE, Mills WJ. et al. Functional outcomes of severe bicondylar tibial plateau fractures treated with dual incisions and medial and lateral plates. J Bone Joint Surg Am 2006; 88: 1713-1721
• 43 Harma A, Inan M. [Emergency pelvic external stabilization as the first step treatment in high risk pelvic fractures]. Ulus Travma Acil Cerrahi Derg 2004; 10: 115-122
• 44 Govaert G, Siriwardhane M, Hatzifotis M. et al. Prevention of pelvic sepsis in major open pelviperineal injury. Injury 2012; 43: 533-536
• 45 Lerner A, Fodor L, Keren Y. et al. External fixation for temporary stabilization and wound management of an open pelvic ring injury with extensive soft tissue damage: case report and review of the literature. J Trauma 2008; 65: 715-718
• 46 Barei DP, Nork SE, Mills WJ. et al. Complications associated with internal fixation of high-energy bicondylar tibial plateau fractures utilizing a two-incision technique. J Orthop Trauma 2004; 18: 649-657
• 47 Tejwani NC, Achan P. Staged management of high-energy proximal tibia fractures. Bull Hosp Jt Dis 2004; 62: 62-66
• 48 Sirkin M, Sanders R. The treatment of pilon fractures. Orthop Clin North Am 2001; 32: 91-102
• 49 Henry P, Wasserstein D, Paterson M. et al. Risk factors for reoperation and mortality after the operative treatment of tibial plateau fractures in Ontario, 1996–2009. J Orthop Trauma 2015; 29: 182-188