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Vol. 19, Art. 90 (pp. 1265-1275)    |    2018       

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Optimization of tactics of treatment of successful therapy mechanical injury as one of the directions of prevention of osteogenous sepsis

Kondratev I.P., Kashansky Y.B., Polikarpov A.V., Tsapenko V.O.
St. Peterburg, I.I. Dzanelidze research institute of emergency medicine,
192242, Saint-Petersburg, Budapeshtskaya Street, Apt. 3, Lit. A

Brief summary

The article is devoted to the optimization of treatment tactics for patients with severe mechanical trauma for the prevention of osteogenic sepsis. The definitions of the concepts of strategy and tactics of the treatment process in relation to patients with such injuries are presented. The method of using objective criteria for assessing the severity of the condition of the victim and his injury has been identified and determined. The essence of the concepts of ?Damage control? in the treatment of patients with severe mechanical trauma, as well as scales assessing the severity of injuries and the condition of the victim (JSS, RTS, TRJSS, APACHJ, etc.). The essence of the developed in St. Petersburg, I. I. Dzanelidze research institute of emergency medicine individual objective measure of the severity of injury: damage and the condition of the victim - the prediction of the duration and outcome of the period of unstable hemodynamics. The technique and advantages of its use are shown. Materials and methods: The analysis of the treatment of patients with severe mechanical trauma over the period since 2014 has been carried out till 2018. The positive and negative aspects of the application of known algorithms to assist this category of victims are highlighted. A critical assessment was made and a new objective criterion of injury severity was proposed for use. The purpose of this work was to improve the results of treating patients by systematizing the approach and highlighting objective criteria for assessing the severity of injury and the condition of the victims, as well as determining common (strategic) and private (tactical) objectives.


Key words

strategy and tactics of the treatment process, damage control, severe mechanical trauma, polytrauma, osteogenic sepsis.

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