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Trauma Platform Berlin: Establishing a city-wide network for trauma surgery and research

Professor Dr. Sven Märdian studied medicine to become a trauma surgeon, an inevitable career choice for someone so fascinated by it from an early age. A postcard displayed in his office sums up his strong sense of purpose: printed on the front, the words ‘would’, ‘could’ and ‘should’ have all been crossed out and replaced by ‘DO’ in capital letters. Today, Märdian is not only an expert in all kinds of injury patterns, but also acts as Deputy Managing Director of the Center for Musculoskeletal Surgery at Charité – Universitätsmedizin Berlin. Alongside colleagues from other leading Berlin hospitals, he founded ‘Trauma Platform Berlin’, a new multimodal initiative designed to connect their respective trauma clinics across the areas of research, care and preventive medicine, thus benefiting the citizens of Berlin and the advancement of science and clinical practice. He applied for the 2022 Max Rubner Award with this idea – and won. We met Sven Märdian in his office at Campus Virchow-Klinikum to learn more about the project and how it is coming along. 

Professor Märdian, your idea for Trauma Platform Berlin merited the Max Rubner Award two years ago. Could you outline the rationale and relevance of this project? 

There are five Level I trauma centers for serious injuries serving Berlin and the surrounding area: Charité Campus Virchow-Klinikum (CVK), Charité Campus Benjamin Franklin (CBF), Unfallkrankenhaus Berlin (UKB), the Vivantes Clinic in Friedrichshain and the Helios Hospital in Berlin-Buch. We basically decided to apply for the Rubner Award because we felt that these five large healthcare providers could be more closely connected than before through an overarching platform. For example, Trauma Platform Berlin now allows standardized data from a very diverse range of injury patterns to be consolidated for detailed analysis, to a far greater extent than is possible with the national trauma register. This should enable us to investigate how accident and injury numbers could be brought down in the long term and identify necessary preventive measures. We also want to introduce a rotation program for further training to enable medical and care teams to exchange knowledge across the individual clinics. Although all injured patients in Berlin are treated according to the latest principles of modern trauma care and receive support in the post-treatment phase, each center has its own area of expertise: we are the leading center for children’s traumatic injuries in greater Berlin, for example, whereas the UKB is the place for spinal cord injuries. The Vivantes Clinic in Friedrichshain has a special pressure chamber in which infectious disease patients can undergo hyperbaric oxygen therapy. Our colleagues there have naturally built up specialist expertise in that area. We can all learn from each other – as we should.

Sven Märdian

Funding program
Max Rubner Award

Year awarded

Trauma Surgery

Developing interactive clinical case reports for dental schools using 3D models and chatbots

Charité – Universitätsmedizin Berlin


2019 – present
Deputy Managing Director of the Center for Musculoskeletal Surgery (CMSC), Charité – Universitätsmedizin Berlin

2018 – present
Emergency Response Coordinator at Charité – Universitätsmedizin Berlin

Habilitation: “Treatment Outcomes and Innovative Approaches to Optimizing the Osteosynthetic Stabilization of Periprosthetic Femoral Fractures”

For those less familiar with the terminology here, what does Level I Trauma Center mean?

In Germany, we have a three-tier trauma system with local, regional, and national trauma centers. National centers are the top level, i.e. Level I. We are essentially the hospital that can do everything, offering patients the highest level of surgical care. We have a wide range of specialists and equipment at our disposal.

You hinted that the scope of the data in the national trauma register is limited. How does Trauma Platform Berlin complement it? What are the respective strengths and weaknesses of each initiative?

Every trauma center in Germany must submit data to the German trauma register which was introduced in the early nineties by the German Society for Trauma Surgery (DGU). At the time, it was a pioneering initiative internationally speaking. Since then, every patient has received a standardized entry in the database, as they should. But the usefulness of these records has its limits. They serve as a good basis for us to look at general trends like whether or not traffic accidents are on the decline, which injury patterns are more prevalent now compared to the past, or whether the introduction of airbags has affected the type and severity of injuries sustained in car accidents. So these data are useful for epidemiological studies. But the national trauma register is too superficial for what we had in mind here in Berlin. We want to go into greater depth with Trauma Platform Berlin to answer questions of the kind that we posed in our joint lab study: what course do infections take after a stab wound? Can we identify prognostic markers among a patient’s laboratory parameters? But as you might guess from hearing this example, this is only possible on a small scale as it involves collecting a huge amount of data – you’ve got to have the motivation, not to mention the storage capacity.

What motivated you and your colleagues Dr. Tobias Topp (CBF), PD Dr. Denis Gümbel (UKB), Prof. Dr. Thomas Fuchs (Vivantes), and Dr. med. Alexander Ringk (Buch) to establish this platform?

In Berlin, we have a relatively unique set of patients from a metropolitan area of over four and a half million people – sadly with the usual social problems for an area of such size. Over the last five to ten years, we have seen an increase in aggression, in stabbings… things that you used to know only from the movies have become the norm. You can hardly work a shift at the large healthcare providers in Berlin without being affected by knife crime these days. I feel as though the potential for violence has only increased since Covid, or else people’s inhibitions are lower. To put it bluntly, people who used to fight with their fists now turn to knives, while those who used to use knives have moved to guns. 

We have got to respond to this new reality. That’s what motivates us. Again, in very simple terms, trauma surgeons have spent the last twenty years dealing with broken bones, but now we are suddenly seeing bullet wounds, penetrative trauma – including casualties from Ukraine, who are regularly flown over to us. These are totally different patterns of injury with different standards of care and treatment techniques. We have been unused to these injuries for so long, but now they are making a comeback.

What stage are you at in implementing this project? What have you already achieved and what still needs to be done?

The underlying concept for Trauma Platform Berlin is multilayered, with three core pillars: further training for medical and healthcare professionals, research and preventive medicine, and communicating preventive measures to the general public in the city. We first focused on research because we wanted to get started as quickly as possible, and we imagined that this was the area furthest away from contractual obligations and legal hurdles. Two projects are now complete, and the results have already been published: the lab study I mentioned earlier, and another study on emergency thoracotomy (a surgical procedure to open the chest). A third and fourth project are currently in progress. We are essentially using our research to generate the content for the preventive courses that we are planning for ordinary citizens. These had originally been planned for last year, but since we started to think bigger, we need more time: we now want to bring all the Berlin clinics on board through their respective emergency response officers so as to reach as much of the general public as possible. We also want to work with the Berlin Senate because the issues like aggression and stabbings that I mentioned before are not just medical problems – they are also social issues relevant to politics.

As for further training, there are still some final legal hurdles to clear regarding secondments, but I’d say that we are on the home stretch. Once this is sorted, we can get started with the rotation programs. 

We have held an internal Trauma Review Meeting at the Charité since 2017, and it is now held across the whole Platform on a monthly basis. It enables us to recap what is going on with our colleagues throughout the entire emergency response chain: which serious injuries did our respective clinics treat over the last month? What can we all learn from these cases? Where do we see opportunities to improve our processes? 

We still need to recruit a central coordinator for Trauma Platform Berlin, someone who is happy to travel around Berlin and meet in person with the liaison officers in each of the participating clinics – in short, someone who can be a point of contact for everyone and coordinate our studies and rotation programs. Unfortunately, we have yet to fill this role due to a lack of stable funding. This might soon change thanks to a recent development: the trauma surgery center here at Campus Virchow-Klinikum has now become a G-BA Trauma Center!

Congratulations! What does this mean for you – and is there a connection between this new status as a G-BA Center and your work on Trauma Platform Berlin?

As a G-BA Trauma Center, we can now deliver services for other clinics and their patients and receive refinancing from health insurance funds in return. We will take the lead in Berlin, supporting other clinics with tools like telemedicine, as well as acting as a central hospital for the whole region in case of disaster. Our new duties are based on the regulations of the Federal Joint Committee, which is abbreviated as G-BA in German. Certain factors were instrumental in our being awarded this status, including our focus on building networks and further training opportunities across different clinics. We have already been able to address both these aspects while building Trauma Platform Berlin – all thanks to the prize money from Stiftung Charité in 2022. Trauma Platform Berlin was, in a sense, a pilot program that served as a basis for our application to become a G-BA Center. What started as our work with the platform is now our official mission as a G-BA Trauma Center for all the clinics in the Berlin network. It is a great development, a kind of Trauma Platform 2.0 – a long-term structure that will enable us to expand the initial good idea and successful collaboration. Getting it up and running won’t be easy, but we have learned a lot through our work on Trauma Platform Berlin. The cooperation agreements for exchanging data, for instance, will serve as a blueprint for our contracts with the clinics in the G-BA network.

We are delighted to hear how the initiative has taken off. 
Now looking back, what led you to become a trauma surgeon? Did you ever imagine that you would end up in this field?

The short answer: I studied medicine to become a trauma surgeon. It was a pretty straight path. I started out at a medium-level hospital in terms of specialist care, before moving to the university hospital. I have now been at the Charité for 15 years – I joined in 2009 as a specialist-in-training at the Center for Musculoskeletal Surgery. [Märdian laughs:] God, I’m old!

And what would you advise students who are contemplating this specialism, but who are less sure that it is the right choice for them?

For a start, orthopedics/trauma surgery is an extremely broad subject that was only consolidated like this in 2005 on the basis that each area involves musculoskeletal systems. Before then, it was two separate subjects. Students at the Charité who are considering going into trauma surgery should take the compulsory elective module ‘Emergency and Disaster Response Medicine’. We first developed it years ago in coordination with the German army and have taught it every semester since. You get a good insight into just how varied the work of a trauma surgeon is. Even today, I still find it exciting that I never know what kind of injuries I will be operating on tomorrow. You’ve got to take on whatever challenge comes your way.

Marike de Vries & Dr. Nina Schmidt / February 2024