Fast track surgery
Under fast-track surgery (English, mutatis mutandis as "fast track" surgery), also known as fast-track rehabilitation referred, refers to a therapeutic concept. It aims to avoid general complications after surgical interventions by applying evidence-based treatment measures. The aim of these treatment measures is to accelerate the convalescence of the patient, to restore the homeostasis disturbed by the operative trauma and to preserve the patient's autonomy. One component of fast-track rehabilitation is the rapid postoperative mobilization of the patient on the day of the operation. A side effect that is particularly interesting from an economic point of view is the considerably shorter length of stay in hospital after an operation due to the faster recovery.
development
At the end of the 1990s, Prof. Kehlet from Copenhagen ( Denmark ) developed a multimodal therapy after operations in the abdominal cavity . The aim was to reduce general risks and recover faster.
Both financial considerations and experience of complications from prolonged immobilization and parenteral nutrition encouraged the development of Fast-Track. The concept has been adopted in many countries, mostly in a modified form. The promoter of the ideas in Germany was Professor Wolfgang Schwenk from the Berlin Charité .
activities
- Preoperative motivational conversation with an emphasis on the patient's active role in recovery
- Already preoperative installation of a pain catheter ( peridural catheter )
- Elimination of preoperative colonic irrigation
- Shortening of the preoperative sobriety
- If possible, use laparoscopic surgical procedures or transverse abdominal incisions
- minimal substitution ( infusions ) during surgery
- earliest postoperative mobilization
- Immediate diet and avoidance of parenteral nutrition
- Follow-up care by the hospital and family doctor