[Can one treat cases of multiple trauma in several stages? (author's transl)]

Treat a case of multiple trauma in a single operative session is an ideal which in practice meets with several obstacles. A study of 125 cases of multiple trauma of which 66 were treated in one stage and 55 in several stages permits in spite of the difficulty of such a comparison, several conclusions. The mortality is not increased in cases of multiple operations, on the contrary, as we noted 27 p. cent of deaths in cases operated on in one stage, and only 15 p. cent in cases submitted to repeated surgery. The complications observed in lesions of the limbs were less numerous (8.8 p. cent) when operation was deferred. In fact, lesions treated as an emergency gave rise to 14 p. cent complications. In spite of the difficulty of interpretation of these figures due to the large number of factors influencing the results, it seems possible to affirm that it is not only possible but even advisable to operate on cases of multiple trauma in several stages, visceral lesions which endanger life and open fractures are the only lesions requiring emergency treatment. The other lesions should be operated on during one or several later stages drawing up a careful plan in relation to the lesions and their localisation.