Professional Documents
Culture Documents
David H. Masjhoer
SMF Orthopedi & Traumatologi
RSU AW Syahranie/FK UNMUL
definition
Importance of fracture
Wound of bone and soft tissue, giving rise to
stress, pain and haemorrhage
Can cause contaminate and compartment
syndromes with ischemia-reperfusion injury
Instability of fracture
Secondary
survey
Resuscitation
Oxygenation,
perfusion
Evaluation
Vital function ?
Response ?
Damage
control
scoring
Life saving
surgery
ICU
Delayed
primary
surgery
Realized by :
Haemostasis
Debridement
Fasciotomy
Fracture fixation
Tension free wound
coverage
Physiological
( -- )
Status
Response to
resuscitation
(?)
Surgical
Intervention
Hyper-inflammation
Window of Opportunity
Live-Saving Surgery
Damage Control
Delayed Primary Surgery
Second look, only
Scheduled definitive surgery
Immunosuppression
No Surgery
Recovery
Secondary reconstructive
Surgery
(+)
Timing
Day 1
Day 2-3
Day 5-10
Week 3
First insult
Moderate SIRS
Moderate Immunosuppression
11
First insult
Moderate SIRS
Moderate Immunosuppression
2nd
Insult
Severe
Immunosuppression
Definitive
Surgery
12
First insult
MOF
Moderate SIRS
Moderate Immunosuppression
2nd
Insult
Severe
Immunosuppression
Definitive
Surgery
13
First insult
MOF
Moderate SIRS
Moderate Immunosuppression
2nd
Insult
Definitive
Surgery
Severe
Immunosuppression
Infection
14
First insult
MOF
Moderate SIRS
Moderate Immunosuppression
2nd
Insult
Definitive
Surgery
MOF
Severe
Immunosuppression
Infection
15
MOF
Definitive Surgery
First insult
Moderate SIRS
Moderate Immunosuppression
2nd
Insult
Definitive
Surgery
MOF
Severe
Immunosuppression
Infection
16
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