Choice of the system for evaluating the severity of combat surgical injuries in the wounded with gunshot defects of soft tissues at medical support levels І-ІІ

Authors

  • I. P. Khomenko National Academy of Medical Sciences of Ukraine
  • E. M. Khoroshun Kharkiv National Medical University Military Medical Clinical Center of the Northern Region of the Medical Forces Command of the Armed Forces of Ukraine, Kharkiv
  • V. V. Makarov Kharkiv National Medical University Military Medical Clinical Center of the Northern Region of the Medical Forces Command of the Armed Forces of Ukraine, Kharkiv
  • V. V. Nehoduiko Kharkiv National Medical University Military Medical Clinical Center of the Northern Region of the Medical Forces Command of the Armed Forces of Ukraine, Kharkiv
  • S. V. Tertyshnyi Military Medical Clinical Center of the Southern Region of the Medical Forces Command of the Armed Forces of Ukraine
  • V. P. Maidaniuk Military Medical Clinical Center of the Southern Region of the Medical Forces Command of the Armed Forces of Ukraine
  • B. Wais Hospital Charite, Berlin, Germany

DOI:

https://doi.org/10.11603/2414-4533.2022.3.13386

Keywords:

GDST (gunshot defects of soft tissues), level of medical support, assessment of the severity of combat surgical trauma, PI

Abstract

The aim of the work: to study the features of the combination of PI and AdTs during the diagnostic algorithms and medical process in wounded with gunshot defects of soft tissues and to prove its effectiveness.

Materials and Methods. Our study included 342 wounded, among whom 128 were wounded in the main group and 214 were wounded in the comparison group. In the main group, all 128 (100 %) injured persons with traumatic blast injuries were admitted to the first level of medical care. Medical assistance at the first level was provided by servicemen of the Armed Forces of Ukraine in the order of self- and mutual aid in 87 (68.0 %) cases, paramedics-instructors – in 26 (20.3 %), paramedics – in 12 (9.4 %), doctors – in 3 (2.3 %). Comparison group included 214 injured persons with GDST who were the original flow. After providing first-level medical care, 74 (34.6 %) wounded who had a mild injury according to the AdTS and PI scale, 112 (52.3 %) had a serious injury, and 28 (13.1%) had an extremely serious injury. According to the planimetric classification of GDST, 14 (6.5 %) of the wounded had extra-large injuries, 70 (32.7 %) had large injuries, and 130 (60.8 %) of the comparison group had medium-sized injuries.

Results and Discussion. Analyzing the obtained results, it is possible to conclude that it is necessary to determine the severity of CST in the injured with GDST at the levels of medical support precisely according to the proposed method. A quick objective assessment of the severity of CST in the injured with GDST was an integral component of the choice of differentiated tactics of providing surgical care to the wounded with a multimodal approach to GDST reconstruction, infusion-transfusion therapy and determination of the possibility of medical evacuation. According this the scale of AdTS and PI should be considered complex diagnostic criteria for the severity of CST in injured persons with GDST, which make it possible to assess the state of peripheral blood flow and to optimize the methods of intensive therapy in a timely manner and to choose the appropriate surgical tactics of treatment.

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Published

2022-10-05

How to Cite

Khomenko, I. P., Khoroshun, E. M., Makarov, V. V., Nehoduiko, V. V., Tertyshnyi, S. V., Maidaniuk, V. P., & Wais, B. (2022). Choice of the system for evaluating the severity of combat surgical injuries in the wounded with gunshot defects of soft tissues at medical support levels І-ІІ. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (3), 5–12. https://doi.org/10.11603/2414-4533.2022.3.13386

Issue

No. 3 (2022)

Section

ORIGINAL INVESTIGATIONS

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