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Erschienen in: Notfall +  Rettungsmedizin 2/2018

05.03.2018 | CME

Update zu Schussverletzungen der Extremitäten

verfasst von: Dr. F. von Lübken, G. Achatz, B. Friemert, M. Mauser, A. Franke, E. Kollig, D. Bieler, AG Einsatz‑, Katastrophen- und Taktische Chirurgie der Deutschen Gesellschaft für Unfallchirurgie

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 2/2018

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Zusammenfassung

Schussverletzungen sind durch Amokläufe und Terroranschläge erneut ins Bewusstsein gerückt, obwohl sie per se in Europa selten sind. Gut die Hälfte aller Schussverletzungen betrifft die Extremitäten. Um die Folgen eines Extremitätenbeschusses verstehen, ist Basiswissen zur Wundballistik unumgänglich. Die ans Gewebe abgegebene Energie des Projektils bestimmt die Verletzungsschwere. Die Energie ist abhängig von der verwendeten Waffe und der Munition. Unterschieden wird zwischen Niedrigenergie-, z. B. durch Pistolen, und Hochenergieverletzungen, v. a. durch Gewehre. Durch die höhere Energieabgabe an das Gewebe entsteht bei Letzteren neben dem permanenten Wundkanal die temporäre Wundhöhle mit erheblichen Weichteilschäden. Frakturen sind bei Hochenergieverletzungen deutlich ausgeprägter als bei Niedrigenergieverletzungen. Débridement gilt als sinnvolle therapeutische Maßnahme. Frakturen sollten aufgrund der häufigen Kontamination temporär mithilfe eines Fixateur externe versorgt werden.
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Metadaten
Titel
Update zu Schussverletzungen der Extremitäten
verfasst von
Dr. F. von Lübken
G. Achatz
B. Friemert
M. Mauser
A. Franke
E. Kollig
D. Bieler
AG Einsatz‑, Katastrophen- und Taktische Chirurgie der Deutschen Gesellschaft für Unfallchirurgie
Publikationsdatum
05.03.2018
Verlag
Springer Medizin
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 2/2018
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-018-0424-9