Methods: 18 C57BL/6-mice equipped with a sk<strong>in</strong>fold chamber conta<strong>in</strong><strong>in</strong>g a musculocutaneous flap were assigned to 3 experimental groups: 1. One session of 500 SW impulses at 0.15mJ/mm 2 applied 24hrs before (precondition<strong>in</strong>g) or 2. applied 30m<strong>in</strong> after flap elevation (postcondition<strong>in</strong>g). 3. Untreated flaps (control). Tissue necrosis, microhemodynamics, <strong>in</strong>flammation, apoptosis and angiogenesis were assessed by <strong>in</strong>travital epi-fluorescence microscopy over 10 days. Results: SW significantly reduced flap necrosis <strong>in</strong>dependent from the application time-po<strong>in</strong>t (precondition<strong>in</strong>g: 29±7%; postcondition<strong>in</strong>g: 25±7% vs. control: 47±2%; d10, p
were grouped <strong>in</strong>to four age groups and their course of treatment and outcome analyzed us<strong>in</strong>g univariate and pend<strong>in</strong>g multivariate comparison (SPSS 17.0 software). Results: In our patient collective, 129 patients (7.1%) were older than 75 years, and 494 patients (27.4%) were between 50 and 75 years of age. Although comparable with respect to <strong>in</strong>jury severity (mean ISS 30-33) and age-adjusted APACHE score, there was a significant <strong>in</strong>crease <strong>in</strong> overall mortality beyond the age of 50 (75 years: 64.3%), with age be<strong>in</strong>g an <strong>in</strong>dependent predictor of mortality. Despite a similar percentage of patients suffer<strong>in</strong>g from head <strong>in</strong>juries (mean 69%) of comparable severity (mean abbreviated <strong>in</strong>jury score (AIS) 4.36), mortality of head <strong>in</strong>juries was highest <strong>in</strong> patients >75 years (70.2%, p 75 years of age were four times more likely to undergo comfort therapy only, and only half as likely to undergo craniotomy for <strong>in</strong>tracranial hemorrhage. Patients > 50 years of age required significantly shorter ICU care than patients below 50 years of age (e.g., 9 days <strong>in</strong> patients > 75 years vs. 14 days <strong>in</strong> patients < 25 years). Conclusion: With <strong>in</strong>creas<strong>in</strong>g life expectancy and susta<strong>in</strong>ed <strong>in</strong>dependence, elderly trauma patients have become a regular occurrence <strong>in</strong> trauma services. Despite comparable <strong>in</strong>jury severity and physiologic status upon admission, these patients suffer from disproportionately high mortality rates. Closed head <strong>in</strong>juries account for the majority of fatalities, regardless of the tim<strong>in</strong>g and extent of therapeutic measures applied. 38.6 Trauma <strong>in</strong>jury <strong>in</strong> patients over 80 years old: an epidemiological study D. Haeni, E. Testa, C. Freuler, A. Kuhrmeier, R. Rosso, C. Candrian, M. Arigoni (Lugano) Objective: Because of the <strong>in</strong>creas<strong>in</strong>g longevity <strong>in</strong> our population the amount of elderly <strong>in</strong>jured patients is constantly grow<strong>in</strong>g. This study is aimed to determ<strong>in</strong>e the epidemiology of <strong>in</strong>jured patients aged 80 years or more admitted <strong>in</strong> a regional hospital. Methods: Data of trauma patients aged 80 and older admitted to our surgical department dur<strong>in</strong>g the year 2008 where retrospectively collected. The follow<strong>in</strong>g epidemiological parameters were analysed and compared to the literature: social parameters, <strong>in</strong>jury location, complication rate, length of hospital stay and discharge location. Results: Dur<strong>in</strong>g 2008 a total of 2783 admissions occurred <strong>in</strong> our department of general surgery whith 761 patients over 80 years old. 260 of these were admitted because of an <strong>in</strong>jury (12 patients were admitted more than once) with a sex ratio F:M of 3:1. These patients suffered a total of 374 <strong>in</strong>juries of which 54% where fractures, 16% non surgical bra<strong>in</strong> <strong>in</strong>juries and 30% <strong>in</strong>juries (contusions, wounds, etc). The distribution of the fracture location was as follows: lower extremity 55% (of which 89% proximal femur); upper extremity 27% (of which 47% proximal humerus); axial skeleton 18%. In patients over 90 years old upper extremity fractures were significantly less frequent than <strong>in</strong> patients between 80 and 89 years old (15,9% versus 30%). Fractures where treated operatively <strong>in</strong> 70,5% of the cases. Mean length of stay was 9,3 days. Complication rate was 35% with a <strong>in</strong>-hospital mortality of 2,3%. Only 25% could return directly home while the other patients were discharged <strong>in</strong> an other <strong>in</strong>stitution (rehabilitation cl<strong>in</strong>ic, retirement home, other hospital). Conclusion: In our region 5,7% of the population is aged 80 and over and <strong>in</strong> our study this age bracket accounts for 27,3% of the admissions <strong>in</strong> our surgical department dur<strong>in</strong>g 2008. Of this patient population 34,1% were admitted because of a traumatic <strong>in</strong>jury. The frequency of fractures of the lower extremity (specially proximal femur fractures) is higher than of the upper extremity and <strong>in</strong>creases with age. Complication is high but reflects the high co-morbidity rate of this population. Because of the low return to home rate the medical and social care of these patients is not limited to the acute hospital and this clearly results <strong>in</strong> a high socioeconomic impact to our society. The results of this study are similar to other studies. 38.7 Patients, treatment and outcome follow<strong>in</strong>g polytrauma - everyth<strong>in</strong>g worse <strong>in</strong> the elderly patient? M. Schüepp, C. Attenberger, I. Füglistaler-Montali, F. Amsler, T. Gross (Basel) Objective: The elderly patient is expected to suffer higher mortality and lower quality of life follow<strong>in</strong>g major trauma. We were <strong>in</strong>terested <strong>in</strong> the possible impact of age on specific patient, trauma, treatment and outcome characteristics follow<strong>in</strong>g polytrauma (<strong>in</strong>jury severity score, ISS>16). Methods: M<strong>in</strong>imum 2-year follow-up survey of 237 prospectively collected consecutive patients (42.8+/-20.9 years; 73.4% male; 96.6% blunt trauma; ISS 29.5+/-11.5) at a university center. Univariate test<strong>in</strong>g (t-test, ANOVA, chi-square). Results: Median 2.5 years follow<strong>in</strong>g <strong>in</strong>jury 180 patients had survived (40.2+/-19.9 years, 73% male, ISS 26.3+/-7.9; 30-day mortality 22.8%). Non-survivors on average were older and more severely <strong>in</strong>jured (both p
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