Progress in care and treatment of multiple trauma patients during the last twenty years

During the last 20 years, the increase in polytrauma has stimulated scientific development and brought about new activities in the field of patient can, Of these new activities, the early treatment of shock by first aid measures and intensive therapy are of greatest importance. In the operative approach, the atraumatic method of operation with the help of new technical devices, instruments, and implants has stood the test of time. A remarkable development arose in the operative treatment of fractures, which plays a decisive role in polytrauma on account of the high rate of bone injuries as well as for reasons of general patient support. The operative treatment of abdominal, craniocerebral, and thoracic injuries was improved not so much by changing operative technics, but rather by vigorous treatment of shock and intensive medical support which have decisively changed the magnitude and timing of the surgery that can be performed to aid the patient. By this means, as well as by newly developed diagnostic possibilities, the necessary conditions for an effective operative treatment have been greatly improved. Thus, at present, more complete primary care of the injured may be carried out successfully in a large percentage of trauma victims.