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Biomedical subjects

M Schweins

Publications and source records attributed to M Schweins.

6 recordsLinked to original sources
PubMed2001

[Hernia repair--which technique? Help in making the decision].

Operation of the inguinal hernia is the most common operation in general surgery. Many criteria influence the kind of operation the surgeon will perform. Detailed anatomic knowledge of the inguinal region, standardised tactical and technical performance of the operation team, careful preparation and a minimum of blood loss reduce complications to low levels. These items are the same for all operation methods. The Shouldice procedure has been the golden standard for many years, nowadays (1998) in America in more than 80% of operations a mesh is implanted in the abdominal wall. A Cochran review of EBM showed advantages for mesh repair compared to nonmesh repair. Patient oriented decision making in choosing a method for inguinal hernia repair should be the new standard of modern general surgery.

Evidence-Based Medicine↗
PubMed1997

[Ambulatory laparoscopic cholecystectomy].

A total of 140 patients underwent outpatient laparoscopic cholecystectomy in an outpatient clinic. Evaluation and follow-up of the patients were done prospectively. Population and preoperative data were comparable to published studies of patients operated on in hospitals. There were no serious intra- or postoperative complications. Postoperatively, patients needed less pain medication, were less tired and returned to work earlier than patients after clinical laparoscopic cholecystectomies. Outpatient laparoscopic cholecystectomy offers a good alternative to patients with moderate operative risks (ASA 1-3). It could reduce costs in the German health system and would be therefore highly cost effective.

Adult↗
PubMed1997

[Effectiveness and economics of private practice established surgeons, exemplified by ambulatory laparoscopic cholecystectomy in 1994 and 1996].

Ambulatory laparoscopic cholecystectomy is a safe procedure providing high patient satisfaction if performed by an experienced surgeon. These are the results of a prospective documentation of 150 outpatients to undergo laparoscopic cholecystectomy between 1994 and 1996. Patients returned to work early (mean 13.2 days off). No patient had to be admitted to hospital following ambulatory operation. All patients declared that they would have the operation performed in the same way a second time if necessary at all. Looking at the money earned for the ambulatory operation compared to the costs, there is a deficit of nearly DM 800 with each performance. Despite the good results and the great satisfaction on the part of the patients, outpatient laparoscopic cholecystectomy will not be widely performed until and unless the surgeons costs are at least covered.

Absenteeism↗
PubMed1993

Assessment of emergency care in trauma patients.

There are many reasons for evaluation of an emergency care system, such as expenses (1.035 Bio. DM in 1985) and quality control. From January 1, 1987 to December 31, 1987 information on all patients seen by an emergency physician in the field have been recorded prospectively in a standard form by the Cologne emergency medical services. Cologne has 1,000,000 inhabitants and covers an area of 405 km2. The patients' status, diagnosis and therapeutic interventions were recorded. Trauma patients were further assessed as to time of accident, cause of accident, and trauma score. All trauma patients with a trauma score < 16 were followed up to their discharge from the hospital. In 1987, 2,073 trauma patients were treated. Overall mortality at the time of discharge was 9.2%. This result alone, however, is not sufficient for assessment of the trauma system. It is important to provide better information on the patient. The trauma evaluation score already used in the US became also a valid instrument in West-Germany. It shows a high correlation between survival and the patients' physiological status in the field. Standard curves could be established for comparing individual or regional trauma systems.

Brain Damage, Chronic↗