[From casualty medicine to casualty surgery]. / Von der Unfallheilkunde zur Unfallchirurgie.

ABSTRACT

For many centuries the treatment of accident casualties -- as proven by evidence from prehistoric times -- has been an essential part of an empirically determined and crafts-oriented surgery. But though the phenomenon of accident and the pathophysiological complex of trauma were faced with the surgical inaccessibility of the human body until in the late 19th century, a kind of casualty medicine supported by multifaceted, scientifically founded observations was trying to repair or alleviate the sequelae of accidents. But only the development of imaging diagnostic procedures made it possible to apply pre-planned target-oriented -- what is modernly called "outcome-oriented" -- surgical procedures. The change in the nature of accidents and their associated health and social consequences demands that the surgeons' attention be specially drawn to this challenge as it presents itself e.g. in the huge field of fracture management, the management of the general sequelae of trauma, emergency rescue and the prevention and control of the secondary effects of trauma (rehabilitation). There has never been any doubt that all this could only be achieved within the discipline of surgery in its entirety, though with the scientifically and practically acquired competence of one its specialties, i.e. casualty surgery, as both a prerequisite and necessary condition.