[Therapeutic principles and priorities of polytrauma in general surgery (author's transl)].

The absolutely prior task in patients with multiple injuries is to maintain the cardiac and pulmonary functions. Furthermore a quick decision is needed regarding additional life-saving operations. Apart from a careful clinical investigation simple diagnostic procedures are necessary (chest x-ray, peritoneal lavage). The life of the injured person is endangered through hemorrhages. The most effective therapy is to recognize and to stop these bleedings. The surgical repair of intestinal ruptures, injuries to the pancreas, ruptures of the diaphragm and other problems can be postponed. The same applies to most of the thoracic injuries, except to the tension pneumothorax. Mediastinal injuries require the use of the heart-lung-machine, if the heart and the big vessels are involved. The extent of an operation and the intraoperative procedure are determined by the injury.