Central German hospitals rely on "fast-track" method
Many clinics in central Germany rely on a modern therapy concept for orthopedic surgery. The "fast-track" method is all about better pre- and aftercare of the patients.
At least five major clinics in central Germany are using the rehabilitation method known as "fast-track" or "rapid recovery" in orthopedic surgery or intend to introduce it soon. This resulted in a request of the MDR magazine "Hauptsein Gesund" at the ten largest hospitals in Saxony, Saxony-Anhalt and Thuringia. While the university hospitals in Halle and Leipzig and the HELIOS Klinikum Erfurt announced that they were already working on this approach, Leipzig's St. Georg Hospital and the Dresden University Hospital announced plans to implement a changeover. From January 2020, the University Hospital of Dresden intends to further optimize the previous preparation and follow-up for surgery as well as the operative interventions itself.
Only a few clinics hesitate
Restraint on the subject of the "fast-track" method is expressed by the Klinikum Chemnitz. "We have not fully implemented this procedure," it says on request of "the main thing healthy". Because the preoperative optimization and mobilization is only possible in young, agile and very athletic patients. But since many older patients would be treated, then "fast track" is often not possible. The Waldklinik Gera, on the other hand, said that in orthopedics it was generally not possible to work according to this method: one was not convinced of the benefit for the patients.
"Healing in the fast lane"
What makes Fast Track so special? Above all, the patient quickly gets back on his feet. The training starts before the operation. In a preparatory course, the patients get to know doctors, physiotherapists, the social service and the environment. "It takes a load off the patients, they no longer come to surgery as strangers in a strange place, but they know: what awaits me?
That makes a big mental difference ", explains Prof. Andreas Roth, orthopedic surgeon and head of endoprosthetics at the University of Leipzig, where patients have been offered the so-called" fast-track "method for one year. "In recent years, much has improved, the artificial joints, surgical methods or anesthetic options. But the processes around the OP have remained the same. We have changed that now, "says Prof. Roth.
In the preparatory course, the patient is also taught which technique best works with the crutches after the operation. "It's important to quickly normalize the gait pattern after the operation, all patients are limping through the pain, we want to quickly strengthen the weakened muscles and thus achieve better patient satisfaction."
And: Even during the operation, the wound is supplied with pain medication: "This comes from the children's orthopedics.To ensure that the children have no pain, surgery has injected a narcotic into the wound.We are now doing the same in the adult and have found that they can then run painlessly after the operation, "explains Prof. Roth.
Patients should then get up as soon as possible after surgery. This eliminates Mobilisierungsschienen, with which the operated leg was previously moved passively. Improved wound dressings require less wound drainage. And in the end, it is minor things that make patients start the rehabilitation program more motivated, such as having to go to the bathroom alone or do not have to wear a hospital shirt.
The success of the fast-track method is measurable: "Patients have less pain, less pain catheters and fewer complications, and the risk of thrombosis or pneumonia is much lower if patients recover quickly The need for blood transfusions is also significantly lower in the fast-track group than in other patients, "explains Prof. Roth.