Dresing, Klaus

[["dc.bibliographiccitation.firstpage","487"],["dc.bibliographiccitation.issue","3"],["dc.bibliographiccitation.journal","European Journal of Trauma and Emergency Surgery"],["dc.bibliographiccitation.lastpage","497"],["dc.bibliographiccitation.volume","46"],["dc.contributor.author","Spering, Christopher"],["dc.contributor.author","Lefering, Rolf"],["dc.contributor.author","Bouillon, Bertil"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","von Eckardstein, Kajetan"],["dc.contributor.author","Dresing, Klaus"],["dc.contributor.author","Sehmisch, Stephan"],["dc.date.accessioned","2021-04-14T08:26:13Z"],["dc.date.available","2021-04-14T08:26:13Z"],["dc.date.issued","2019"],["dc.identifier.doi","10.1007/s00068-019-01229-8"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/81874"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-399"],["dc.relation.eissn","1863-9941"],["dc.relation.issn","1863-9933"],["dc.title","It is time for a change in the management of elderly severely injured patients! An analysis of 126,015 patients from the TraumaRegister DGU®"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","18"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Operative Orthopädie und Traumatologie"],["dc.bibliographiccitation.lastpage","22"],["dc.bibliographiccitation.volume","32"],["dc.contributor.author","Saul, Dominik"],["dc.contributor.author","Roch, Jonathan"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Dresing, Klaus"],["dc.date.accessioned","2020-06-08T13:13:06Z"],["dc.date.available","2020-06-08T13:13:06Z"],["dc.date.issued","2019"],["dc.description.abstract","Ziel Komplette Anästhesie der Phalangen an Hand und Fuß. Indikationen Erkrankungen an Hand oder Fuß distal des Grundgelenks bis zum Endglied. Kontraindikationen Lokale Infektionen an der Injektionsstelle. Verletzungen proximal des Grundgelenks. Technik An der Basis des Fingers oder Zehs wird distal des Grundgelenks dorsoradial und -ulnar ein subkutanes Depot eines 0,5–2 %-igen Lokalanästhetikums gesetzt. Unter Vorschieben der Kanüle nach palmar werden dann weitere 0,5–1,5 ml appliziert, um eine komplette Anästhesie des Fingers/Zehs zu erreichen. Weiterbehandlung Die Wirkung der Lokalanästhesie ist selbstlimitierend. Ergebnisse Die Leitungsanästhesie nach Oberst bewirkt eine zuverlässige Betäubung von Finger und Zeh. Chirurgische Eingriffe distal des Grundgelenks lassen sich hiermit schmerzfrei durchführen."],["dc.description.abstract","Objective Complete anesthesia of the phalanges of the fingers and toes. Indications All lesions distal to the metacarpophalangeal/metatarsophalangeal joint. Contraindications Local infections at the injection site. Lesions proximal to the metacarpophalangeal/metatarsophalangeal joint. Technique A subcutaneous deposit of a 0.5–2% local anesthetic is administered dorsoradially and dorsoulnarly at the base of the metacarpophalangeal/metatarsophalangeal joint. With the cannula advanced to palmar, an additional 0.5–1.5 ml is then administered to achieve complete anesthesia. Postoperative management The effect of the local anesthesia is self-limiting. Results The Oberst block results in reliable anesthesia of the finger and toe. All surgical procedures distal to the metacarpophalangeal/metatarsophalangeal joint can be performed without pain."],["dc.identifier.doi","10.1007/s00064-019-00633-y"],["dc.identifier.pmid","31650198"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/66199"],["dc.language.iso","de"],["dc.relation.eissn","1439-0981"],["dc.relation.issn","0934-6694"],["dc.title","Leitungsanästhesie nach Oberst"],["dc.title.alternative","Oberst’s block anesthesia"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.subtype","original_ja"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.journal","European Journal of Trauma and Emergency Surgery"],["dc.contributor.author","Spering, Christopher"],["dc.contributor.author","Brauns, Soehren Dirk"],["dc.contributor.author","Lefering, Rolf"],["dc.contributor.author","Bouillon, Bertil"],["dc.contributor.author","Dobroniak, Corinna Carla"],["dc.contributor.author","Füzesi, László"],["dc.contributor.author","Seitz, Mark-Tilmann"],["dc.contributor.author","Jaeckle, Katharina"],["dc.contributor.author","Dresing, Klaus"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Frosch, Stephan"],["dc.date.accessioned","2022-05-02T08:09:31Z"],["dc.date.available","2022-05-02T08:09:31Z"],["dc.date.issued","2022"],["dc.description.abstract","Abstract Introduction Time is of the essence in the management of severely injured patients. This is especially true in patients with mediastinal vascular injury (MVI). This rare, yet life threatening injury needs early detection and immediate decision making. According to the ATLS guidelines [American College of Surgeon Committee on Trauma in Advanced Trauma Life Support (ATLS ® ), 10th edn, 2018], chest radiography (CXR) is one of the first-line imaging examinations in the Trauma Resuscitation Unit (TRU), especially in patients with MVI. Yet thorough interpretation and the competence of identifying pathological findings are essential for accurate diagnosis and drawing appropriate conclusion for further management. The present study evaluates the role of CXR in detecting MVI in the early management of severely injured patients. Method We addressed the question in two ways. (1) We performed a retrospective, observational, single-center study and included all primary blunt trauma patients over a period of 2 years that had been admitted to the TRU of a Level-I Trauma Center. Mediastinal/chest (M/C) ratio measurements were calculated from CXRs at three different levels of the mediastinum to identify MVI. Two groups were built: with MVI (VThx) and without MVI (control). The accuracy of the CXR findings were compared with the results of whole-body computed tomography scans (WBCT). (2) We performed another retrospective study and evaluated the usage of sonography, CXR and WBCT over 15 years (2005–2019) in level-I–III Trauma Centers in Germany as documented in the TraumaRegister DGU ® (TR-DGU). Results Study I showed that in 2 years 267 patients suffered from a significant blunt thoracic trauma (AIS ≥ 3) and met the inclusion criteria. 27 (10%) of them suffered MVI (VThx). Through the initial CXR in a supine position, MVI was detected in 56–92.6% at aortic arch level and in 44.4–100% at valve level, depending on different M/C-ratios (2.0–3.0). The specificity at different thresholds of M/C ratio was 63.3–2.9% at aortic arch level and 52.9–0.4% at valve level. The ROC curve showed a statistically random process. No significant differences of the cardiac silhouette were observed between VThx and Control (mean cardiac width was 136.5 mm, p  = 0.44). Study II included 251,095 patients from the TR-DGU. A continuous reduction of the usage of CXR in the TRU could be observed from 75% in 2005 to 25% in 2019. WBCT usage increased from 35% in 2005 to 80% in 2019. This development was observed in all trauma centers independently from their designated level of care. Conclusion According to the TRU management guidelines (American College of Surgeon Committee on Trauma in Advanced Trauma Life Support (ATLS®), 10th edn, 2018; Reissig and Kroegel in Eur J Radiol 53:463–470, 2005) CXR in supine position is performed to detect pneumothorax, hemothorax and MVI. Our study showed that sensitivity and specificity of CXR in detecting MVI was statistically and clinically not reliable. Previous studies have already shown that CXR is inferior to sonography in detecting pneumothorax and hemothorax. Therefore, we challenge the guidelines and suggest that the use of CXR in the early management of severely injured patients should be individualized. If sonography and WBCT are available and reasonable, CXR is unnecessary and time consuming. The clinical reality reflected in the usage of CXR and WBCT over time, as documented in the TR-DGU, seems to support our statement."],["dc.description.abstract","Abstract Introduction Time is of the essence in the management of severely injured patients. This is especially true in patients with mediastinal vascular injury (MVI). This rare, yet life threatening injury needs early detection and immediate decision making. According to the ATLS guidelines [American College of Surgeon Committee on Trauma in Advanced Trauma Life Support (ATLS ® ), 10th edn, 2018], chest radiography (CXR) is one of the first-line imaging examinations in the Trauma Resuscitation Unit (TRU), especially in patients with MVI. Yet thorough interpretation and the competence of identifying pathological findings are essential for accurate diagnosis and drawing appropriate conclusion for further management. The present study evaluates the role of CXR in detecting MVI in the early management of severely injured patients. Method We addressed the question in two ways. (1) We performed a retrospective, observational, single-center study and included all primary blunt trauma patients over a period of 2 years that had been admitted to the TRU of a Level-I Trauma Center. Mediastinal/chest (M/C) ratio measurements were calculated from CXRs at three different levels of the mediastinum to identify MVI. Two groups were built: with MVI (VThx) and without MVI (control). The accuracy of the CXR findings were compared with the results of whole-body computed tomography scans (WBCT). (2) We performed another retrospective study and evaluated the usage of sonography, CXR and WBCT over 15 years (2005–2019) in level-I–III Trauma Centers in Germany as documented in the TraumaRegister DGU ® (TR-DGU). Results Study I showed that in 2 years 267 patients suffered from a significant blunt thoracic trauma (AIS ≥ 3) and met the inclusion criteria. 27 (10%) of them suffered MVI (VThx). Through the initial CXR in a supine position, MVI was detected in 56–92.6% at aortic arch level and in 44.4–100% at valve level, depending on different M/C-ratios (2.0–3.0). The specificity at different thresholds of M/C ratio was 63.3–2.9% at aortic arch level and 52.9–0.4% at valve level. The ROC curve showed a statistically random process. No significant differences of the cardiac silhouette were observed between VThx and Control (mean cardiac width was 136.5 mm, p  = 0.44). Study II included 251,095 patients from the TR-DGU. A continuous reduction of the usage of CXR in the TRU could be observed from 75% in 2005 to 25% in 2019. WBCT usage increased from 35% in 2005 to 80% in 2019. This development was observed in all trauma centers independently from their designated level of care. Conclusion According to the TRU management guidelines (American College of Surgeon Committee on Trauma in Advanced Trauma Life Support (ATLS®), 10th edn, 2018; Reissig and Kroegel in Eur J Radiol 53:463–470, 2005) CXR in supine position is performed to detect pneumothorax, hemothorax and MVI. Our study showed that sensitivity and specificity of CXR in detecting MVI was statistically and clinically not reliable. Previous studies have already shown that CXR is inferior to sonography in detecting pneumothorax and hemothorax. Therefore, we challenge the guidelines and suggest that the use of CXR in the early management of severely injured patients should be individualized. If sonography and WBCT are available and reasonable, CXR is unnecessary and time consuming. The clinical reality reflected in the usage of CXR and WBCT over time, as documented in the TR-DGU, seems to support our statement."],["dc.identifier.doi","10.1007/s00068-022-01966-3"],["dc.identifier.pii","1966"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/107400"],["dc.language.iso","en"],["dc.notes.intern","DOI Import GROB-561"],["dc.relation.eissn","1863-9941"],["dc.relation.issn","1863-9933"],["dc.rights.uri","https://creativecommons.org/licenses/by/4.0"],["dc.title","Diagnostic value of chest radiography in the early management of severely injured patients with mediastinal vascular injury"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","893"],["dc.bibliographiccitation.issue","11"],["dc.bibliographiccitation.journal","Der Unfallchirurg"],["dc.bibliographiccitation.lastpage","900"],["dc.bibliographiccitation.volume","121"],["dc.contributor.author","Spering, C."],["dc.contributor.author","Roessler, M."],["dc.contributor.author","Kurlemann, T."],["dc.contributor.author","Dresing, K."],["dc.contributor.author","Stürmer, K. M."],["dc.contributor.author","Lehmann, W."],["dc.contributor.author","Sehmisch, S."],["dc.date.accessioned","2020-12-10T14:08:30Z"],["dc.date.available","2020-12-10T14:08:30Z"],["dc.date.issued","2017"],["dc.identifier.doi","10.1007/s00113-017-0447-6"],["dc.identifier.eissn","1433-044X"],["dc.identifier.issn","0177-5537"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/70478"],["dc.language.iso","de"],["dc.notes.intern","DOI Import GROB-354"],["dc.title","Optimierte Ressourcenmobilisation und Versorgungsqualität Schwerstverletzter durch eine strukturierte Schockraumalarmierung"],["dc.title.alternative","Optimized resource mobilization and quality of treatment of severely injured patients through a structured trauma room alarm system"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","4"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","Operative Orthopädie und Traumatologie"],["dc.bibliographiccitation.lastpage","12"],["dc.bibliographiccitation.volume","32"],["dc.contributor.author","Saul, Dominik"],["dc.contributor.author","Roch, Jonathan"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Dresing, Klaus"],["dc.date.accessioned","2020-06-09T06:53:32Z"],["dc.date.available","2020-06-09T06:53:32Z"],["dc.date.issued","2019"],["dc.description.abstract","Zielsetzung Vollständige Anästhesie von Haut und Weichteilen durch intradermale oder subkutane oder intramuskuläre Injektionen. Indikationen Kleinere Verletzungen oder Inzisionen an Extremitäten oder Körperstamm, kleinere operative Eingriffe im Gesicht/am Kiefer (z. B. an den Zähnen) oder postoperative Analgesie (lokale Infiltrationsanästhesie, LIA). Kontraindikationen Lokale Infektionen unmittelbar an der Injektionsstelle. Technik Mittels intradermaler, subkutaner oder intramuskulärer Applikation entsteht eine Erhabenheit, hier wird durch das Lokalanästhetikum die Nervenweiterleitung blockiert. Sofern distal von Endarterien anästhesiert wird, sollte auf einen Vasokonstriktor (z. B. Epinephrin) verzichtet werden. Proximal von Endarterien hingegen kann eine lokal begrenzte Ischämie gegebenenfalls die operative Versorgung vereinfachen. Weiterbehandlung Die Wirkung der Lokalanästhesie ist selbstlimitierend. Ergebnisse Mittels Infiltrationsanästhesie oder „Feldblock“ werden größere Hautareale problemlos einer operativen Versorgung zugängig. Dabei ist die zu applizierende Menge dem Ausmaß der Operation und vor allem der Dosierungsobergrenze anzupassen. Postoperativ kann insbesondere nach Knie- oder Hüft-Totalendoprothese der Analgetikaverbrauch reduziert und die frühe Mobilisierung mittels LIA vorangetrieben werden."],["dc.description.abstract","Objective Complete anesthesia of any skin and soft tissue area by intradermal, subcutaneous, or intramuscular injections. Indications Small injuries or incisions in limbs or trunk, minor surgery on the face/jaw (e.g., on the teeth), or postoperative analgesia (local infiltration anesthesia, LIA). Contraindications Local infections at the injection site. Surgical technique By means of intradermal, subcutaneous or intramuscular administration, a grandeur arises, here the local anesthetic blocks nerve transmission. If anesthetized distal to end arteries, vasoconstrictors (e.g., epinephrine) should be avoided. Proximal to end arteries, localized ischemia may facilitate operative care. Postoperative management The effect of local anesthesia is self-limiting. Results By means of infiltration anesthesia or “field block”, larger areas of skin are easily accessible for surgical treatment. The amount to be applied has to be adapted to the extent of the operation and the maximal dose. Postoperatively, after knee or hip arthroplasty, analgesia consumption can be reduced, and early mobilization promoted using LIA."],["dc.identifier.doi","10.1007/s00064-019-00630-1"],["dc.identifier.pmid","31612258"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/66208"],["dc.language.iso","de"],["dc.relation.eissn","1439-0981"],["dc.relation.issn","0934-6694"],["dc.title","Infiltrationsanästhesie"],["dc.title.alternative","Infiltration anesthesia"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.artnumber","e000408"],["dc.bibliographiccitation.issue","1"],["dc.bibliographiccitation.journal","BMJ Open Sport & Exercise Medicine"],["dc.bibliographiccitation.volume","4"],["dc.contributor.author","Krüger, Lara"],["dc.contributor.author","Hohberg, Maike"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Dresing, Klaus"],["dc.date.accessioned","2019-07-09T11:49:39Z"],["dc.date.available","2019-07-09T11:49:39Z"],["dc.date.issued","2018"],["dc.description.abstract","Background/aim: Horse riding is a popular sport, which bears the risk of serious injuries. This study aims to assess whether individual factors influence the risk to sustain major injuries. Methods: Retrospective data were collected from all equine-related accidents at a German Level I Trauma Centre between 2004 and 2014. Logistic regression was used to identify the risk factors for major injures. Results: 770 patients were included (87.9% females). Falling off the horse (67.7%) and being kicked by the horse (16.5%) were the two main injury mechanisms. Men and individuals of higher age showed higher odds for all tested parameters of serious injury. Patients falling off a horse had higher odds for being treated as inpatients, whereas patients who were kicked had higher odds for a surgical therapy (OR 1.7) and intensive care unit/intermediate care unit (ICU/IMC) treatment (OR 1.2). The head was the body region most often injured (32.6%) and operated (32.9%). Patients with head injuries had the highest odds for being hospitalised (OR 6.13). Head or trunk injuries lead to the highest odds for an ICU/IMC treatment (head: OR 4.37; trunk: OR 2.47). Upper and lower limb injuries showed the highest odds for a surgical therapy (upper limb: OR 2.61; lower limb: OR 1.7). Conclusion: Risk prevention programmes should include older individuals and males as target groups. Thus a rethinking of the overall risk assessment is necessary. Not only horseback riding itself, but also handling a horse bears a relevant risk for major injuries. Serious head injures remain frequent, serious and an important issue to be handled in equestrians sports."],["dc.identifier.doi","10.1136/bmjsem-2018-000408"],["dc.identifier.pmid","30364519"],["dc.identifier.purl","https://resolver.sub.uni-goettingen.de/purl?gs-1/15731"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/59597"],["dc.language.iso","en"],["dc.notes.intern","Merged from goescholar"],["dc.rights","CC BY-NC 4.0"],["dc.rights.uri","https://creativecommons.org/licenses/by-nc/4.0"],["dc.subject.ddc","610"],["dc.title","Assessing the risk for major injuries in equestrian sports"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.version","published_version"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.journal","Operative Orthopädie und Traumatologie"],["dc.contributor.author","Spering, Christopher"],["dc.contributor.author","von Hammerstein-Equord, Alexander"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Dresing, Klaus"],["dc.date.accessioned","2021-04-14T08:30:53Z"],["dc.date.available","2021-04-14T08:30:53Z"],["dc.date.issued","2020"],["dc.identifier.doi","10.1007/s00064-020-00688-2"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/83400"],["dc.language.iso","de"],["dc.notes.intern","DOI Import GROB-399"],["dc.relation.eissn","1439-0981"],["dc.relation.issn","0934-6694"],["dc.title","Osteosyntheseverfahren bei Thoraxwandinstabilität"],["dc.title.translated","Osteosynthesis of the unstable thoracic wall"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dspace.entity.type","Publication"]]

[["dc.bibliographiccitation.firstpage","1063"],["dc.bibliographiccitation.issue","12"],["dc.bibliographiccitation.journal","Der Chirurg"],["dc.bibliographiccitation.lastpage","1069"],["dc.bibliographiccitation.volume","87"],["dc.contributor.author","Spering, Christopher"],["dc.contributor.author","Tezval, Mohammed"],["dc.contributor.author","Dresing, Klaus"],["dc.contributor.author","Burchhardt, H."],["dc.contributor.author","Wachowski, Martin Michael"],["dc.contributor.author","August, Florian"],["dc.contributor.author","Frosch, Stephan"],["dc.contributor.author","Walde, Tim Alexander"],["dc.contributor.author","Stuermer, Klaus-Michael"],["dc.contributor.author","Lehmann, Wolfgang"],["dc.contributor.author","Sehmisch, Stefan"],["dc.date.accessioned","2018-11-07T10:05:08Z"],["dc.date.available","2018-11-07T10:05:08Z"],["dc.date.issued","2016"],["dc.description.abstract","Due to restrictions on admission to medical school, changing claims to an optimized work-life balance and occupational perspectives, surgical professions in particular are struggling with strategies to motivate young academics. Surgical disziplines aim towards a profound transfer of knowledge and pique student's interest by ensuring a sustainable education at university. The goal of this study was to evaluate a Students-On-Call System (SOCS) and to identify a financial benefit. In this study the SOCS was compared pre-/postevaluation using questionnaires and the supporting XaEurorays within a curricular teaching module of orthopedic trauma surgery, with students in the fourth semester of specialism and those in the practical semester at medical school. The students of SOCS showed significantly better results prior to the course and afterwards than the two other groups. By establishing SOCS medical students get involved into the treatment of emergency patients in the trauma resuscitation unit (TRU) and operating room (OR). Students get the chance to enhance their comprehension of diagnostics, therapy and decision making in surgical context. This highly valuable traineeship combines a minimized teaching effort with an effective motivation of young academcis for the surgical profession. A SOCS has reduced the workload of medical colleagues. Establishing SOCS spare the residents being on call and results in reduced costs of 23,659.86 Euro per year. The results presented show that the SOCS leads to an excellent cost-benefit balance, which has been established in multiple surgical departments at the medical school of the University of Gottingen. Apart from practice-oriented surgical teaching, the SOCS is a way of promoting successful young talent saving resources in the medical on-call services."],["dc.identifier.doi","10.1007/s00104-016-0258-2"],["dc.identifier.isi","000389902200010"],["dc.identifier.pmid","27484828"],["dc.identifier.uri","https://resolver.sub.uni-goettingen.de/purl?gro-2/38841"],["dc.notes.status","zu prüfen"],["dc.notes.submitter","Najko"],["dc.publisher","Springer"],["dc.relation.issn","1433-0385"],["dc.relation.issn","0009-4722"],["dc.title","Promoting Young Talents in Trauma Surgery through Students-On-Call"],["dc.type","journal_article"],["dc.type.internalPublication","yes"],["dc.type.peerReviewed","yes"],["dc.type.status","published"],["dspace.entity.type","Publication"]]