{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T11:29:48Z","timestamp":1769254188554,"version":"3.49.0"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Zentralbl Chir"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Durch den aktuellen Krieg in der Ukraine steht die Behandlung von Kriegsverletzungen in der \u00f6ffentlichen Diskussion. Die hierzulande stattfindende Weiterversorgung von Verletzten aus der Ukraine nach Verteilung im Kleeblatt in die TraumaNetzwerke DGU steht nicht zuletzt durch die Forderung des Bundesverteidigungsministeriums und des Bundesgesundheitsministeriums, die Bundeswehr und das deutsche Gesundheitssystem gegen\u00fcber potenziellen Belastungen aus kriegerischen Auseinandersetzungen resilienter (kriegst\u00fcchtig) zu machen, im Fokus.Um ein Verst\u00e4ndnis f\u00fcr die erwartbaren Behandlungsergebnisse, die Vorgehensweisen im Einsatz, aber auch die Unw\u00e4gbarkeiten der Schwerstverletztenversorgung unter Einsatzbedingungen zu etablieren, ist es das Ziel des vorliegenden Artikels, die Besonderheiten der Schwerstverletztenversorgung in kriegerischen Auseinandersetzungen darzustellen.Durch eine Literaturrecherche werden die Herausforderungen und typischen Verletzungsmuster am\n      Beispiel des Einsatzes der Bundeswehr in Afghanistan und des aktuellen Krieges in der Ukraine dargestellt. Es wird ein \u00dcberblick \u00fcber die Faktoren gegeben, die abweichend von der gut etablierten und standardisierten, zivilen Polytraumaversorgung in Deutschland die Vorgehensweisen und die Ergebnisqualit\u00e4t unter Einsatzbedingungen beeinflussen k\u00f6nnen.Die Schwerstverletztenversorgung erfolgt auch im Einsatz der Bundeswehr oder wie aktuell konzipiert f\u00fcr den Einsatz der NATO unter standardisierten Bedingungen, die sich an der algorithmenbasierten Versorgung des ATLS mit Fokus auf Blutungskontrolle orientiert. Dies ist materiell und personell gut etabliert, vorbereitet und geschult.Einzelne L\u00e4ndergegebenheiten bzw. Einsatzerfordernisse k\u00f6nnen aber dazu f\u00fchren, dass die erste \u00e4rztliche notfallmedizinische Versorgung abweichend vom zivilen System in Deutschland erst zeitverz\u00f6gert und nach l\u00e4ngerem Transport erfolgen kann. Ziel ist es hierbei immer, f\u00fcr die eingesetzten\n      Soldaten eine im Ergebnis gleichwertige Versorgung abzubilden, wie sie hier in Deutschland jedem Unfallopfer, unabh\u00e4ngig von Zeit und Ort des Unfalles, potenziell zur Verf\u00fcgung steht.<\/jats:p>","DOI":"10.1055\/a-2348-1043","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:32:20Z","timestamp":1723069940000},"page":"350-358","source":"Crossref","is-referenced-by-count":3,"title":["Schwerstverletztenversorgung in kriegerischen Auseinandersetzungen"],"prefix":"10.1055","volume":"149","author":[{"given":"Axel","family":"Franke","sequence":"additional","affiliation":[{"name":"Department of Trauma, Orthopedic and Reconstructive Surgery and Sportsmedicine, German Armed Forces Hospital Ulm, Ulm, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joachim","family":"Sahm","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Thoracic Surgery, German Armed Forces Central Hospital Koblenz, Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Bieler","sequence":"additional","affiliation":[{"name":"Department of Trauma, Orthopedic and Reconstructive Surgery, Handsurgery and Burn Medicine, German Armed Forces Central Hospital Koblenz, Koblenz, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerhard","family":"Achatz","sequence":"additional","affiliation":[{"name":"Department of Trauma, Orthopedic and Reconstructive Surgery and Sportsmedicine, German Armed Forces Hospital Ulm, Ulm, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,8,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1007\/s00113-023-01395-w","article-title":"Versorgung von Kriegsverletzten aus der Ukraine in den Traumanetzwerken der DGU \u2013 Anspruch, Wirklichkeit und Motivation im Verlauf von 18 Monaten","volume":"127","author":"A Franke","year":"2024","journal-title":"Unfallchirurgie (Heidelb)"},{"issue":"06","key":"ref2","doi-asserted-by":"publisher","first-page":"S395","DOI":"10.1097\/TA.0b013e3182754850","article-title":"Battlefield trauma care then and now: a decade of Tactical Combat Casualty Care","volume":"73","author":"FK Butler jr","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1007\/s00113-019-00735-z","article-title":"[ATLS\u00ae and TDSC\u00ae: how it fits together : A treatment concept for mass casualty and terrorist-related mass casualty situations, life-threatening and special scenarios]","volume":"123","author":"A Franke","year":"2020","journal-title":"Unfallchirurg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"117","DOI":"10.55460\/3WQ1-Z1Z8","article-title":"Review of the Paris Special Operations Forces Combat Medical Care Conference, Fall 2022","volume":"23","author":"P Pasquier","year":"2023","journal-title":"J Spec Oper Med"},{"key":"ref5","volume-title":"\u00dcber Strategie (1871)Milit\u00e4rische Werke, Band 2, Teil 2","author":"H von Moltke","year":"1900"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"13","DOI":"10.15804\/rop2020401","article-title":"Improvement of the organizational and legal mechanism of medical support of the security and defense sector of Ukraine in crises based on NATO standards","volume":"14","author":"A Bakai","year":"2020","journal-title":"Reality of Politics"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1007\/s00134-023-07117-5","article-title":"Intensive care units during the Ukraine war: challenges and opportunities","volume":"49","author":"K Bielka","year":"2023","journal-title":"Intensive Care Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1080\/13523260.2022.2092820","article-title":"Lessons (to be) learned? 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