Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 22, Art. 43 (pp. 619-630)    |    2021       

»

Surgical tactics of providing trauma care to patients with mechanical injuries in trauma centers of various levels

Manukovsky V.A., Lapshin V.N., Kashansky U.B., Kucheev I.O., Kondratiev I.P., Afonchikov V.S., Kotlyarsky A.F., Shalamov D.V., Razumova N.K.

Saint-Petersburg I. I. Dzhanelidze research institute of emergency medicine

Brief summary

The article discusses the issues of alternative approaches to the choice of tactics of trauma care for patients with mechanical injuries in various variants of the course of a traumatic disease. The concept of "Damage control" has become generally accepted in the provision of surgical, including trauma care to patients with shock-induced injuries. At the same time, it must not be forgotten that the method of "dynamic forecasting", which has been used in the clinic for several decades, is successfully applied in practical work. Materials and methods. Based on the method of "dynamic forecasting", a surgical tactic has been developed for providing trauma care to patients not only with severe combined (multiple) trauma but also to patients with bone injuries with relatively low shockogenicity. The versatility of this method is that using available in the clinic functional and laboratory tests to assess the severity of injury, one can get specific recommendations on the tactics of providing anti-shock care in trauma centers of various levels. The purpose of this work is to focus the attention of specialists providing emergency assistance to patients with skeletal trauma of varying severity on the choice of optimal trauma tactics based on the concept of "dynamic forecasting".


Key words

shockogenic trauma, traumatic disease, dynamic forecasting, "Damage control", trauma tactics.

Reference list

1.Abakymov M.M., Bogopolskii P.M. Damage control: chto novogo? Hiryrgiya. Jyrnal im. N.I. Pirogova, 2007, 11, s.59-62.


2.Gymanenko E.K., Boyarincev V.V., Vashenkov V.V., Sypryn T.U. Metodologiya obektivnoi ocenki tyajesti travm (Chast 1. Ocenka tyajesti mehanicheskih povrejdenii). Vestn. hir. -1997, -N2. -C.55-60.


3.Gymanenko E.K., Boyarincev V.V., Sypryn T.U. Metodologiya obektivnoi ocenki tyajesti travm (Chast 3. Ocenka tyajesti ranenih i postradavshih). Vestn. hir. -1997, -N4. -C.22-26.


4.Keer A.N., Frolov G.M., Savelev M.S., Kashanskii U.B. Hiryrgicheskaya taktika pri tyajeloi travme, osnovannaya na obektivnih kriteriyah tyajesti sostoyaniya postradavshih. Vestn. hir. 1982, -7, s.86-90.


5.Kortavenko V.I., Barmina A.A. Sovremennie podhodi k klassifikacii sochetannih povrejdenii i opredeleniu tyajesti sostoyaniya postradavshego. Moskva. 1997, -21s.


6.Tylypov A.N., Manykovskii V.A., Samohvalov I.M., Kajanov I.V., Gavrishyk Ya.V. Principi diagnostiki i lecheniya tyajeloi sochetannoi travmi. Neotlojnaya hiryrgiya imeni I.I.Djanelidze. -2021, N2, -S.11-28.


7.Seleznev S.A., Cibin U.N., Galceva I.V., Nazarenko G.I. Teoreticheskie i prikladnie aspekti problemi prognozirovaniya techeniya i ishoda travmaticheskogo shoka v klinike. Pat. fiziologiya i eksperim. terapiya. -1987, - N2. -C.3-10.


8.Sokolov V.A. Damage control - sovremennaya koncepciya lecheniya postradavshih s kriticheskoi politravmoi. Vestnik travmatologii i ortopedii. 2005, 1, s. 81-84.


9.Sokolov V.A., Byalik E.I., Ivanov P.A., Garaev D.A. Prakticheskoe primenenie koncepcii damage control pri lechenii perelomov dlinnih kostei konechnostei y postradavshih s politravmoi. Vestnik travmatologii i ortopedii. 2005,1, s.3-7.


10.Cibin U.N. Mnogofaktornaya ocenka tyajesti travmaticheskogo shoka. Vestn. hir. -1980, -N9, C.62-67.


11.Charchyan A.G., Gabrielyan L.M., Bahtamyan G.A., Arytunyan G.R., Gulzadyan G.G., Bdoyan G.A., Saribekyan S.A. O ponyatii damage control orthopedics.


12.Shapot U.B., Seleznev S.A. Remizov V.B. Mnojestvennaya i sochetannaya travma, soprovojdaushayasya shokom. Kishenev, 1993g.


13.Baker S.P., O?Neill B., Haddon W.Jr. et al. The injury severity score: a method for describing patients with multiple injuries and evaluation emergency care // J. Trauma. 1974.,V.14., P.187-196.


14.Boid C.R., Tolson M.A., Copls W.S. Evaluating trauma care. J. Trauma. -1987, -Vol.27, N4, -P.370-378.


15.Boss M., Tejwani N.C. Evolving trends in the care of polytrauma patients. Injury, 2004; 37; 1; 20-28.


16.Champion H.R., Sacco W.J., Hunt T.K. Trauma severity scoring. Wld J. Surg. -1983, -Vol.7, N1, -P.4-11.


17.Champion H.R., Sacco W.J., Lepper R.L. et al. An anatomic index of injury severity. J. Trauma. -1980, -Vol.20, -N3, -P.197-202.


18.Knaus W.A., Douglas W., Draper E.A. Development of APACHE // Crit.Care Med. 1989. V.17. P.181-185.


19.Kuhn F., Slezakb Z. Damage control in ocular traumatology // Injury. - 2004. - Vol. 35, 7. - P. 689-695.


20.Taeger G., Ruchholtz S., Waydhas S. [et al.] Damage Control Orthopedics in Patients With Multiple Injuries Is Effective, Time Saving, and Safe // J. Trauma-Injury Infect. Crit. Care. - 2005. - Vol. 59, 2. - P. 408-415.