Milestones

 

1995 – University of Zurich

Postgraduate course in experimental medicine and biology at the Medical Faculty of the University of Zurich (Fig.1) . The first experimental work was carried out in the laboratory of the Clinic for Trauma Surgery at the University Hospital Zurich.

1995-2008 – Clinic for Trauma Surgery, University Hospital Zurich

Basic research – The work on the reduced immune response, the so-called «endotoxin tolerance» in seriously injured patients, (Fig. 2) and the work on the reduced targeted cell death (« apoptosis ») of immune cells in patients with severe infections (sepsis) (Fig. 3) are considered to be groundbreaking publications. Research on cell death and later on wound healing mechanisms in vacuum-assisted wound therapy was supported by the Swiss National Science Foundation.
The description of the acute phase protein PSP (“Pancreatic Stone Protein”) in severely injured patients with a septic course (Fig. 4) led to a patent (PDF1) . The overview work on the pathophysiological mechanisms (pathological functional disorders) in accident patients (Fig. 5) is still one of the world’s most cited and respected «review» articles in trauma medicine.
Clinical research – In the context of holistic trauma surgery with life-saving and damage-limiting operations, case series and review articles received much international attention (Fig. 6 , Fig. 7) . The first internationally published series of pelvic stabilization with a pelvic clamp and additional cloth tamponades for patients with severe pelvic injuries under resuscitation conditions  (Fig. 8) and the largest series of emergency thoracotomies (chest openings for resuscitation and bleeding control) in Europe with one of the world’s best survival rates (Fig. 9) received particular attention.

Another major milestone was participation in the world’s largest prospective randomized study in trauma medicine, in which the influence of blood coagulation factor VII (“Novoseven”) on the use of blood reserves and mortality in severely injured patients with bleeding shock was examined (Fig. 10; «Swiss connection »- article in the study booklet of Novo Nordisk Pharma AG) . However, since the mortality rate in the study was too low, the study was discontinued in 2008, with 541 patients 2.5 years after the start of the study and the most patients in Europe at the Clinic for Trauma Surgery of the University Hospital Zurich under the direction of Prof. Keel (22 Patients). 71 hospitals in Europe, USA, Canada, South America, Oceania, Asia, Africa and Israel participated in the study.

The academic and clinical work of Prof. Keel was honored in 2007 in New Orleans by the American Surgery Society with the admission as a Fellow of the “American College of Surgeons” (Fig. 11a, Fig. 11b, Fig. 11c) .

The constant motivation and inspiration to improve the clinical care of accident victims and also the pathophysiological understanding is to be thanked to Prof. Dr. Dr. h.c. Otmar Trentz, who worked tirelessly like a «Tinguely work of art» as an extraordinary trauma surgeon, teacher and mentor and, as a humanist, was always a great role model for Prof. Keel (Fig. 12; teachers and students in the Tinguely Museum Basel on the occasion of the European trauma and emergency surgery -Congress (ECTES) in Basel 2012) . Unfortunately, when he retired in 2008, Prof. Trentz was refused an appropriate farewell by the University of Zurich and the University Hospital Zurich and the holistic approach of trauma surgery was abandoned in the spirit of specialization. The diploma from Prof. Dr. Dr. h.c. Trentz about Prof. Keel on August 31, 2008 ended with the following honorable words: “Mr. Keel is an“ academic surgeon ”in the best sense of the word. In addition to the acquisition of a high level of clinical competence, he has been extremely committed to research … A retiring boss is proud to say that he has trained and promoted employees in such a way that they are operationally better than the retiring mentor. This applies to Mr. Keel in the best sense. »
Type and date of the surgical / traumatological / orthopedic interventions personally carried out by Prof. Keel for the first time at the Clinic for Trauma Surgery, University Hospital Zurich:

  • First osteosynthesis (surgical connection of bone fragments) on May 27, 1995
  • First laparotomy (opening of the abdominal cavity) on December 6th, 1997
  • First thoracotomy (opening of the chest) on February 19, 1998
  • First hip prosthesis on July 11, 1999
  • First spinal stabilization on January 7th, 2003
  • First pelvic ring osteosynthesis on January 22, 2003
  • First hip revision prosthesis on April 16, 2003
  • First acetabulum (hip joint socket) osteosynthesis on June 10, 2003
  • First surgical hip dislocation to treat an acetabular fracture on January 14, 2004
  • the world’s first osteochondral transplant on the femoral head on June 18, 2007 (Fig. 13; published case report)

2003 – Habilitation University of Zurich

Awarded his habilitation (private lecturer in surgery) on July 1st, 2003 at the University of Zurich. The title of the habilitation thesis was “Dysregulation of the apoptosis of neutrophil granulocytes – meaning for the immunological “CHAOS” after trauma. This work describes different mechanisms of cell death regulation of immune cells in severely injured patients. The inaugural lecture entitled “The Seriously Injured Man in the Tension Between Specialization and Economics” took place in the full auditorium of the University of Zurich on April 3rd, 2004 (Fig. 14) .