{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T23:41:54Z","timestamp":1765496514730,"version":"3.48.0"},"reference-count":30,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Handchir Mikrochir Plast Chir"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die Versorgung offener Frakturverletzungen mit ausgepr\u00e4gtem\n                        Hautweichteildefekt stellt eine gro\u00dfe Herausforderung f\u00fcr Gesundheitssystem\n                        dar. Grundlage einer erfolgreichen und effizienten Versorgung dieser\n                        Patienten ist ein fr\u00fcher interdisziplin\u00e4rer Behandlungsansatz zwischen\n                        Traumatologie und Plastischer Chirurgie im Sinne des \u201eorthoplastischen\n                        Ansatzes\u201c. Ziel dieser \u00dcbersichtsarbeit ist es, die Behandlungsergebnisse\n                        derjenigen Patienten zu vergleichen, welche entweder direkt vom Unfallort\n                        (prim\u00e4r) in ein Level-1-Traumazentrum verlegt wurden, und jenen, die erst im\n                        Verlauf verlegt wurden (sekund\u00e4r).<\/jats:p>\n                  <jats:p>Die systematische \u00dcbersichtsarbeit wurde unter Einhaltung der PRISMA\n                        Guidelines erstellt. Die Literatursuche erfolgte in der Datenbank MEDLINE.\n                        Es konnten 14 Studien zur Datenanalyse eingeschlossen werden. In der\n                        Auswertung wurde, abh\u00e4ngig vom Verlegungszeitpunkt zwischen einer prim\u00e4ren\n                        (PRI) oder sekund\u00e4ren (SEK) Gruppe unterschieden. Die erhobenen Outcomes\n                        waren der Zeitpunkt der Verlegung, die Krankenhausverweildauer, die\n                        Zeitpunkte bis zur ersten operativen Versorgung, der definitiven kn\u00f6chernen\n                        Fixierung und der Weichteilrekonstruktion, die Gesamtzahl der Operationen,\n                        die Rekonstruktionsverfahren und deren Komplikationen, sowie Non-Unions und\n                        Infektionen.<\/jats:p>\n                  <jats:p>Es konnten 14 Studien mit insgesamt 5294 behandelten Patienten eingeschlossen\n                        werden. Der Anteil an GA\u2265Typ IIIB klassifizierten Frakturen betrug 88,6%.\n                        Die Krankenhausverweildauer lag bei der prim\u00e4ren Gruppe im Median bei 26,6\n                        Tagen und war damit k\u00fcrzer als bei den sekund\u00e4r verlegten Patienten mit 35,2\n                        Tagen. Sowohl f\u00fcr die Zeitpunkte bis zur ersten operativen Versorgung, als\n                        auch bis zur definitiven kn\u00f6chernen Fixierung und abschlie\u00dfenden\n                        Weichteilrekonstruktion, zeigten sich Verz\u00f6gerungen f\u00fcr die sekund\u00e4r\n                        verlegten Patienten. Die prim\u00e4r verlegten Patienten zeigten eine geringere\n                        Gesamtzahl an Operationen und Osteomyelitis.<\/jats:p>\n                  <jats:p>Die versp\u00e4tete sekund\u00e4re Verlegung in ein Level-1-Traumazentrum kann mit\n                        relevanten Nachteilen f\u00fcr die Patienten verbunden sein. Neben der zeitlichen\n                        Komponente stellt die fr\u00fchzeitige Erstellung eines rekonstruktiven\n                        Behandlungsplanes durch ein interdisziplin\u00e4res und spezialisiertes Team\n                        einen entscheidenden Faktor dar. So kann die Gesamtzahl notwendiger\n                        Eingriffe reduziert und das funktionelle Outcome verbessert werden. Das Ziel\n                        sollte die prim\u00e4re Umsetzung des orthoplastischen Behandlungsansatzes sein,\n                        wof\u00fcr spezialisierte Traumazentren die besten Voraussetzungen bieten.<\/jats:p>","DOI":"10.1055\/a-2653-5893","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T22:44:53Z","timestamp":1761086693000},"page":"436-448","source":"Crossref","is-referenced-by-count":0,"title":["Vergleich der Behandlungsergebnisse bei prim\u00e4rer vs. sekund\u00e4rer\n                    Verlegung in ein Level-1-Traumazentrum bei Gustilo-Anderson\u2265Typ IIIB Frakturen \u2013\n                    Eine systematische \u00dcbersichtsarbeit"],"prefix":"10.1055","volume":"57","author":[{"given":"Oliver","family":"Ritthaler","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Replantations- und Mikrochirurgie, Zentrum f\u00fcr\n                    Schwerbrandverletzte und Plastsiche Chirurgie, BG Klinikum Unfallkrankenhaus\n                    Berlin, Lehrstuhl f\u00fcr Hand-, Replantations- und Mikrochirurgie, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosima","family":"Prahm","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Replantations- und Mikrochirurgie, Zentrum f\u00fcr\n                    Schwerbrandverletzte und Plastsiche Chirurgie, BG Klinikum Unfallkrankenhaus\n                    Berlin, Lehrstuhl f\u00fcr Hand-, Replantations- und Mikrochirurgie, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claas","family":"G\u00fcthoff","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Replantations- und Mikrochirurgie, Zentrum f\u00fcr\n                    Schwerbrandverletzte und Plastsiche Chirurgie, BG Klinikum Unfallkrankenhaus\n                    Berlin, Lehrstuhl f\u00fcr Hand-, Replantations- und Mikrochirurgie, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katrin","family":"Wulfert","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Replantations- und Mikrochirurgie, Zentrum f\u00fcr\n                    Schwerbrandverletzte und Plastsiche Chirurgie, BG Klinikum Unfallkrankenhaus\n                    Berlin, Lehrstuhl f\u00fcr Hand-, Replantations- und Mikrochirurgie, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Aman","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Replantations- und Mikrochirurgie, Zentrum f\u00fcr\n                    Schwerbrandverletzte und Plastsiche Chirurgie, BG Klinikum Unfallkrankenhaus\n                    Berlin, Lehrstuhl f\u00fcr Hand-, Replantations- und Mikrochirurgie, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Harhaus-W\u00e4hner","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Hand-, Replantations- und Mikrochirurgie, Zentrum f\u00fcr\n                    Schwerbrandverletzte und Plastsiche Chirurgie, BG Klinikum Unfallkrankenhaus\n                    Berlin, Lehrstuhl f\u00fcr Hand-, Replantations- und Mikrochirurgie, Charit\u00e9\n                    Universit\u00e4tsmedizin Berlin, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Berlin,\n                    Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/J.INJURY.2011.12.007","article-title":"The epidemiology of open fractures in adults. 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