Preface; Contents; 1: The Impact of Trauma on Society; 1.1 Introduction; 1.2 The Psychological Implications of Trauma; 1.3 Chronic Pain and Disability Due to Trauma; 1.4 Return to Work After Trauma; 1.5 Global Trends and Perspectives on Trauma; Conclusion; References; 2: Economic Aspects of Trauma Care; 2.1 Introduction; 2.2 Cost of Illness; 2.3 Prevention; 2.4 Economic Evaluation of Health Technologies in Trauma Care; 2.5 Economic Aspects of Multiple/Severe Injuries in Hospital Care; References; 3: Evidence-Based Orthopaedic Trauma Care; 3.1 Origins; 3.2 Present State

3.3 Evidence-Based Approach3.3.1 Ask; 3.3.2 Acquire; 3.3.3 Appraise; 3.3.4 Apply; 3.3.5 Act; 3.4 Challenges; 3.5 Future Directions; 3.6 Models for Success in Orthopaedic Trauma Care; 3.7 Origins; 3.8 Formalization and Funding; 3.9 Commitment; 3.10 Research Coordinators; 3.11 Biannual Meetings; 3.12 Operationalization of the EBM Approach; Conclusion; References; 4: Inflammatory Changes and Coagulopathy in Multiply Injured Patients; 4.1 Introduction; 4.2 Damage-Associated Molecular Patterns; 4.3 Acute-Phase Reaction; 4.4 Immune Response After Multiple Injury

4.5 Activation and Dysfunction of the Serine Protease Systems4.5.1 The Coagulation System: Coagulopathy; 4.5.2 The Complement System: Complementopathy; 4.5.3 The Kallikrein-Kinin System; 4.6 Cytokines; 4.6.1 Pro-inflammatory Cytokines; 4.6.2 Anti-inflammatory Cytokines; 4.7 Reactive Oxygen Species (ROS); 4.8 Cells Implicated in Multiple Trauma; 4.8.1 Neutrophils; 4.8.2 Monocytes/Macrophages; 4.8.3 Natural Killer Cells; 4.9 Mechanisms of the Development of Organ Dysfunction; 4.9.1 Severity of Initial Injury (First Hit); 4.9.2 Two-Hit Theory; 4.9.3 Ischemia/Reperfusion Injury

4.9.4 Barrier Breakdown Conclusion; References; 5: Pathophysiology of Polytrauma; 5.1 Introduction; 5.2 Initial Response; 5.3 Inflammatory Response; 5.4 Clinical Course and Appropriate Actions; 5.5 Clinical Course and Immunomarkers; References; 6: Head Injuries: Neurosurgical and Orthopedic Strategies; 6.1 Introduction; 6.2 Pathophysiology of Head Injury; 6.3 The "Deadly Duo": Hypoxia and Hypotension; 6.4 Clinical Assessment and Management; 6.5 Strategies of Fracture Fixation in Head-Injured Patients; Conclusion; References; 7: Soft Tissue Injuries; 7.1 Introduction

7.2 Challenges of Soft Tissue Injury Associated with Fractures7.2.1 Principles and Classifications; 7.2.2 Hypoxia and Perfusion-related Complications; 7.2.2.1 Tissue Hypoxia [11]; 7.2.2.2 Compartment Syndrome; 7.2.2.3 Venous Tissue Congestion and Thrombosis; 7.2.2.4 Decubitus; 7.2.3 Life Threatening Early Wound Infections; 7.3 Surgical Management; 7.3.1 Acute Surgical Management; 7.3.2 Post-acute Surgical Phase; 7.3.3 Early-Intent Defect Coverage; 7.3.4 Peripheral Nerve System; 7.3.4.1 Plexus Injury; 7.3.4.2 Peripheral Nerve Injury; References; 8: Chest Trauma