Abstract
Introduction: The severity of the combined injury, traumatic shock, blood loss and traumatic prolonged primary surgery are the cause of high mortality injured patients. In civilian medicine, damage control technology is widely used to treat patients with severe polytrauma, which has improved the survival of this group of patients. Objective: Analyze the effectiveness of using "damage control" technology in wounded with polytrauma at the second level of medical care during war conflict in Eastern Ukraine and organization of combat casualty care. Methods: Medical and statistical analysis of the effectiveness medical treatment for patients combat-ralated injuried and polytrauma performed on the basis of a mobile military hospital during 2015-2019 period. Results: In 660 patients with combat multiple and combined injuries and in 1027 - with severe military combined trauma, medical tratment was provide by "damage control" technology. The main task of the first stage of surgery intervention was to stop the bleeding and stabilize the patient condition. 130 patients with intra-abdominal bleeding underwent laparotomy, temporary stop of bleeding, blood sampling for autotransfusion and temporary closure of the abdominal cavity. For the purpose of temporary hemostasis in 15 patients abdominal tamponade was performed, in 26 - liver tamponade, in 24 - splenectomy, in 6 - nephrectomy and in 6 - put the clamps were applied to bleeding vessels. In 14% injured patients definitive stage of surgical procedures were performed at the second level of medical care on the background of abdominal compartment syndrome in 10, visceral edema in 14 and peritonitis in 40 patients. Conclusions: Providing emergency medical treatment, surgical procedures and intensive care at the second level of medical tretment using the technology of "damage control" and timely patients evacuation are the key to reducing mortality and complications of military surgical trauma
Highlights
The severity of the combined injury, traumatic shock, blood loss and traumatic prolonged primary surgery are the causes of high mortality in injured patients
Damage control technology is widely used to treat patients with severe polytrauma, which has improved the survival of this group of patients
Medical and statistical analysis of the effectiveness of medical treatment for patients with combat-related injuries and polytrauma performed within a mobile military hospital during 2015–2019
Summary
The severity of the combined injury, traumatic shock, blood loss and traumatic prolonged primary surgery are the causes of high mortality in injured patients. Modern combat trauma is characterized by multiple and combined injuries, which are accompanied by massive blood loss and traumatic shock. Samokhvalov, in the military conflict in the North Caucasus in 1999–2000, multiple gunshot wounds and injuries accounted for 13.6 % and 12.5 %, and combained of 19.2 % and 24.1 % respectively. 32 % British military and 18 % US military during the Gulf War, had combined injuries [1]. The severity of the combined injury, traumatic shock, blood loss, and traumatic prolonged primary surgery are fatal to many patients, resulting in high mortality among the wounded. The phenomenon of mutual burdening is characteristic of combined trauma and combined injuries [2]
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