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Shock room of the department of orthopaedic trauma, university of ulm) This textbook is a fully updated and revised third edition of a highly successful practical guide to the care of the polytrauma patient. This overview provides new insights in the pathophysiology of the early danger response after polytrauma and outlines the main resulting consequences for surgical management.

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Recent multi center studies provided a “genetic storm” theory, according to which certain neutrophil changes are activated at the time of injury. The third edition of the book has been fully updated and extended to describe the latest techniques and covers the complete content of the ao principles course of today. This approach represents a paradigm shift in the management of polytraumatized patients that is based on the evidence provided by understanding the pathophysiologic mechanisms involved in the setting of polytrauma.

While it was thought for a long time that the direct and indirect effects of hypoperfusion are most relevant due to the endothelial permeability changes, it was discovered that the innate immune response to trauma is equally important in modifying the organ response.