Abstract：
:Background: The fact that medical treatment is associated with errors has long been recognized. Based on the principle of "first do no harm", numerous efforts have since been made to prevent such errors or limit their impact. However, recent statistics show that these measures do not sufficiently prevent grave mistakes with serious consequences. Preventable mistakes such as wrong patient or wrong site surgery still frequently occur in error statistics. Methods: Based on insight from research on human error, in due consideration of recent legislative regulations in Germany, the authors give an overview of the clinical risk management tools needed to identify risks in surgery, analyse their causes, and determine adequate measures to manage those risks depending on their relevance. The use and limitations of critical incident reporting systems (CIRS), safety checklists and crisis resource management (CRM) are highlighted. Also the rationale for IT systems to support the risk management process is addressed. Results/Conclusion: No single tool of risk management can be effective as a standalone instrument, but unfolds its effect only when embedded in a superordinate risk management system, which integrates tailor-made elements to increase patient safety into the workflows of each organisation. Competence in choosing adequate tools, effective IT systems to support the risk management process as well as leadership and commitment to constructive handling of human error are crucial components to establish a safety culture in surgery.
journal_name
Zentralbl Chirjournal_title
Zentralblatt fur Chirurgieauthors
Strametz R,Tannheimer M,Rall Mdoi
10.1055/s-0041-107444subject
Has Abstractpub_date
2017-02-01 00:00:00pages
72-82issue
1eissn
0044-409Xissn
1438-9592journal_volume
142pub_type
杂志文章,评审abstract：:In this case report we discuss the anaesthetic management of newborns with esophageal atresia classified as Vogt III b. This type is characterised by an upper esophageal pouch which ends blindly and a distal tracheoesophageal fistula. Commonly associated diseases are cardiac, renal, vertebral and anal anomalies. The m...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：2000-01-01 00:00:00
abstract：:307 Patients with intraabdominal infections were operated between 8/1988 to 8/1991. Simple clinical parameters (according to the Mannheimer Peritonitis-Index) were evaluated before treatment. The classical therapeutic concept of one-stage laparotomy with drainage of the abdomen was performed in 223 patients initially....
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:Congenital diaphragmatic hernia (CDH) occurs sporadically with an incidence of 1:2,500 live births. Despite the progress in neonatal intensive care, CDH remains associated with a mortality of at least 30 % in isolated cases. The in essence surgically correctable defect of the diaphragm enables the prenatal herniation ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0029-1224604
更新日期：2009-12-01 00:00:00
abstract：UNLABELLED:The preperitoneal approach with implantation of a dacron sheet was applied in 37 patients with recurrent hernias and in 30 patients with primary bilateral hernias. In total 120 hernias were repaired. The patients were controlled prospectively for serious complications. The patients were examined every 3 mont...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1994-01-01 00:00:00
abstract：:Bacterial hepatic abscesses are a rare but serious disease. They develop either secondary to injuries or ischemia of the liver, infections in the drainage area of the portal vein, systemic sepsis or biliary infections. An abscess secondary to injuries or ischemia of the liver or infections in the drainage area of the ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：:In order to define the influence of intestinal obstruction on therapy and prognosis of colorectal carcinoma, we analyzed retrospectively the records of 1756 patients with this type of malignancy (1966-1990). The incidence of obstruction was 8% among our patients (n = 134), 3% of which suffered perforation (n = 4). Ope...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:Modern oncological liver surgery continues to push the limits of resectability by incorporating an array of new developments in the fields of surgery, anaesthesia and intensive care, oncology, radiology and transplantation medicine. New criteria for determining the resectability of primary and secondary liver tumours ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0033-1350815
更新日期：2014-04-01 00:00:00
abstract：:In the early post-operative follow-up after allogenic kidney transplantation sigmoid perforation due to diverticula is a life-threatening complication. As immunosuppression is indispensable perforation is favoured. Due to pharmacotherapy the risk of sepsis is implied because clinical symptoms might be masked. Referenc...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1988-01-01 00:00:00
abstract：BACKGROUND:Postoperative pancreatic fistula is a relevant complication after pancreatoduodenectomy. Therefore, preoperative detection of high risk patients may be important. We evaluated preoperative CT-imaging by planimetry at the expected resection plane along the superior mesenteric vein and correlated the results w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-0035-1546193
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:The prevalence of morbid obesity and its sequelae is increasing in Germany, Europe and worldwide. Bariatric surgery is thus gaining in importance for the treatment of patients with malignant obesity. Creation of a gastric bypass is one of the most frequently performed procedures for obesity. DISCUSSION:The ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0028-1098812
更新日期：2009-02-01 00:00:00
abstract：BACKGROUND:Sacral nerve stimulation (SNS) is an effective and less invasive treatment of faecal incontinence (FI). Patient selection has evolved from strict criteria to a more liberal approach, since temporary testing reliably predicts the efficacy of permanent stimulation in FI of various aetiologies. PATIENTS AND ME...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2008-1004737
更新日期：2008-04-01 00:00:00
abstract：:Extended liver resections are associated with the risk of postoperative liver dysfunction up to liver failure. For this reason, prior to extended liver resections patients are conditioned in multi-modal therapy regimes. Portal vein embolisation is an essential part of such a multi-modal therapy. The aim of this interv...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-0032-1328350
更新日期：2013-08-01 00:00:00
abstract：:Presented is a new technique in preoperative conditioning of the pedicled TRAM-flap employing an interventional-radiologic procedure, selective embolization of the deep inferior epigastric artery (DIEA). During a four year period in 40 patients with a mean age of 48.4 (31-66) years breast reconstruction was performed ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：2000-01-01 00:00:00
abstract：:Missed abdominal injuries after blunt abdominal trauma belong to the most frequent causes of death, especially in polytraumatized patients. Primary missing these injuries often is a tragedy due to a mortality-rate up to 50% after delayed treatment compared with a low complication- and mortality-rate after diagnosis in...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1999-01-01 00:00:00
abstract：:The change of surgical operations from inpatient to outpatient conditions as a method of lowering costs in health care has lead to a significant rise in the number of outpatient operations, especially in varicose vein surgery. Hospitalisation is still required in special cases. The criteria of 146 patients with varico...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2001-16278
更新日期：2001-07-01 00:00:00
abstract：:Forty-eight acute distal aortic occlusions were treated on an inpatient basis from January 1973 to December 1993. The mean age was 66 years. Twenty-seven patients had an acute thrombotic occlusion of the distal aorta, and a cardiogenic embolism was the cause of occlusion in 21 cases. The 43 operated patients evidenced...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1995-01-01 00:00:00
abstract：:The planning of locoregional tumor therapy (radical surgical resection, curative radiotherapy) is based on the knowledge of locoregional tumor spread, in particular lymph node metastasis. In general, lymphatic spread follows anatomic rules, skipping of nodes is observed maximally in 3%. According to tumor site, uni- o...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：10.1055/s-2000-10046
更新日期：2000-01-01 00:00:00
abstract：:Early and late infections are severe complications after osteosynthesis in closed fractures. Using gentamicin chains is an effective form of local treatment in these cases. The indications for the application and different surgical procedures are described and the authors experiences are given. ...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:Electromyography (EMG) of the pelvic floor musculature is only carried out as a routine method in few clinics. There is a lack of standard patient groups and, correspondingly, standardized values do not exist. Close cooperation between proctologists and neurologists is the exception. Some surgeons use the EMG to evalu...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1996-01-01 00:00:00
abstract：:For therapeutic recommendations three different kinds of scores are essential: 1. The severity scores for trauma; 2. Severity scores for mangled extremities; 3. Intensive care scores. The severity of polytrauma patients is measurable by the AIS, ISS, RTS, PTS and TRISS which is a combination of RTS, ISS, age, and mech...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章,评审
doi：
更新日期：1997-01-01 00:00:00
abstract：BACKGROUND:Although in hospitals focussing on minimal invasive surgery laparoscopic appendectomy (LA) is widely practiced as method of choice in patients with acute appendicitis, the decision for the laparoscopic or the conventional technique (OA) is usually ensued by individual viewpoints. Aim of this prospective obse...
journal_title：Zentralblatt fur Chirurgie
pub_type： 临床试验,杂志文章
doi：10.1055/s-2004-836240
更新日期：2005-02-01 00:00:00
abstract：:Psychooncology is an interdisciplinary field that focuses on the various somatic, social and psychological factors influencing the well-being of oncological patients. Although the importance of psychooncological support of cancer patients is well accepted, universal standards for psychooncological care have not been e...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2008-1004664
更新日期：2008-02-01 00:00:00
abstract：:While classical inguinal hernia repair has recently been brought up for discussions among surgeons, at present various modified techniques are being reintroduced in general surgery. Surgical hernia repair techniques which partly are known since several decades are being carried out laparoscopically since 1989. Between...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1993-01-01 00:00:00
abstract：:The aim of this study was to determine the pressure conditions in the tissue beneath and on the surface of wounds. This was done in vitro both on a plain surface and on a bovine muscle. In comparison we measured the pressure of the anterior tibial muscle of a patient with compartment syndrome. Besides, we applied nega...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2004-822650
更新日期：2004-05-01 00:00:00
abstract：:Two surgical methods are compared: resection of the stricture and replacement by large bowel (out of 64 cases, 63 were elective and one emergency), and the usual anti-reflux procedures (13 cases). In this series the mortality rate and the functional results are reported as more favourable after resection and replaceme...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：INTRODUCTION:Shot peening and grit blasting techniques are used to modify surfaces of hip endoprostheses. Alumina blasting techniques using highly pure corund (Al (2)O (3)) particles create a rough surface of Titanium implants to achieve a better osteointegration in cementless total hip arthroplasty. An increasing numb...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2005-836801
更新日期：2005-08-01 00:00:00
abstract：:Between 1978 and 1990 98 patients with gas gangrene were treated in the departments of general surgery and traumatology of the University of Kiel. The microbiological results of tissue samples and results of animal infectious experiments were correlated to the clinical outcome. It could be shown, that gas gangrene due...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:Since 1982 a total number of 1062 patients underwent surgical treatment of bronchogenic carcinoma. There were 972 men and 89 women, with a mean age of 62.5 years. In 484 cases a squamous cell carcinoma was diagnosed and in 416 patients an adenocarcinoma. An alveolar cell carcinoma was found in 54 and a polymorphocellu...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1996-01-01 00:00:00
abstract：INTRODUCTION:In a prospective trial we analysed the results and the management of complications following a combined endovascular and vascular surgical therapy of peripheral occlusive arterial disease (POAD). PATIENTS AND METHODS:From November 1998 until January 2001 a total number of 61 patients with 64 extremities w...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：10.1055/s-2002-22030
更新日期：2002-02-01 00:00:00
abstract：:With the new method of gas exchange and dialysis carried out simultaneously with a standard dialysis module, for the first time normothermic ex-vivo whole blood perfusion of pig kidneys becomes practicable under nearly physiological conditions. To show the possibility of animal experiment replacements we use slaughter...
journal_title：Zentralblatt fur Chirurgie
pub_type： 杂志文章
doi：
更新日期：1998-01-01 00:00:00
