The effectiveness of the approximation of specialized medical care to the sanitary losses zone using the multidisciplinary surgical reinforcement groups

Abstract

The analysis of the organization and results of specialized surgical care in peacetime and wartime is presented. It is demonstrated that in order to comply with the principle of bringing medical care closer to the zone of emergency situations and/or combat operations, it is important to recruit military medical staff as multidisciplinary specialized surgical groups of medical reinforcement. By the forces and means of such a group, the conversion of medical institutions located closely to the centers of sanitary losses is carried out, followed by the reception of victims and the provision of emergency specialized (including high-tech) medical care of the surgical profile. The analysis of the reinforcement of the stages of medical evacuation for the provision of specialized (including high-tech) medical care of the surgery profile was carried out. During providing medical care to the injured and wounded in the North Caucasian armed conflict in the second half of the 20th early 21st centuries, the best results were achieved by deploying multidisciplinary military hospitals of the 1st echelon on the basis of garrison located near the area of military operations. The 1st echelon hospitals were reinforced by multidisciplinary medical reinforcement groups from military medical organizations of central subordination. Specialized (including high-tech) surgical medical care provided in multidisciplinary hospitals of the first echelon included general surgical procedures (35.4%), operations on the chest and abdominal cavity (19.8%), interventions performed by narrow specialists (otorhinolaryngological, maxillofacial, ophthalmological, urological) 17.7%, trauma operations (17.0%), interventions on arterial and venous vessels (8.2%), as well as on the brain (2.4%). During the evaluation of the experience of the medical reinforcement groups, their medical and statistical indicators are presented and proposals are made to change their staffing structures, taking into account the spectrum of damaging factors and the range of lesions in the event of natural and man-made emergencies, as well as during modern wars and armed conflicts.