Surgical help to wounded persons, suffering military abdominal trauma on stages of medical evacuation of the level III medical support during conduction of Antiterrorist operation on the east of Ukraine
Objective. To determine the ways of improvement in results of delivery of surgical help to the wounded persons with the battle abdominal trauma (BAT) in conditions of military conflict on the east of Ukraine.
Materials and methods. Delivery of surgical help was analyzed in 707 wounded persons with BAT on stages of medical evacuation (SME) Level III of the medical help delivery during conduction of Antiterrorist operation (ATO). Two groups of observation were implemented: GS–1 and GS–2. Into GS–1 were included 402 wounded persons, to whom surgical help was delivered in first two periods of ATO, when the military actions intensity was maximal; and into GS–2 – 305 wounded persons, in whom surgical help was delivered in third period, which was characterized by lowering of the battle intensity, optimization of system of treatment–evacuation support (TES), systematic application of the proposed scale for estimation of the trauma severity Admission trauma score (AdTS), Focused Assessment with Sonography for Trauma (FAST)–protocol and tactic of the Damage Control Surgery (DCS).
Results. Reduction of the morbidities percentage was achieved: from 76.6% in the operated wounded persons GS–1 to 44.0% in the operated wounded persons GS–2, and lethality lowering by 2.7% for the wounded persons with severe and extremely severe BAT were achieved.
Conclusion. Using surgical interventions in borders of the tactics DCS phases in all volume with further conduction of operations in accordance to the “Second look” program, relaparotomies and programmed relaparotomies on background of optimization of a TES system have improved the results of the surgical help delivery in the wounded persons with BAT on the SME level III of the medical help delivery while conduction of ATO.
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