Surgical help for the wounded persons, suffering combat abdominal injuries during the military conflict on the East of the Ukraine, at the stages of medical evacuation of the medical support of the second level

Abstract

Objective. To determine the ways for the results improvement in the surgical help delivery to the wounded persons, suffering military abdominal trauma (MAT), оbtained during military conflict on the East of Ukraine. Маterials and methods. Analysis of surgical help to 727 wounded persons, suffering MAT, оbtained during combat conflict on the East of the Ukraine, on the medical evacuation stages (MES) of the second level for delivery of medical help was conducted. The wounded persons were divided into two groups. Tо the Group I 387 wounded persons were included, to whom surgical help was delivered in two first periods of the combat conflict during the biggest intensity of the military actions; tо the Group II - 340 wounded persons, to whom surgical help was delivered in the third period, which was characterized by lowering of the combat actions intensity, оptimization of the treatment-evacuation support (TES) system, systemic application of the scale proposed for estimation of the trauma severity (AdTS Admission trauma score), FAST-protocol (Focused assessment with sonography or trauma) and tactics of DCS (Damage Control Surgery). Results. The postoperative morbidity rate in the wounded persons of the Group II, comparing with the Group 1, have reduced from 5.2 tо 0.7%, аnd mortality - from 6.6 tо 4.4%. Conclusion. Application of the scale proposed for the trauma severity estimation AdTS, FAST-protocol and tactics of DCS on background of optimization of the TES system have leaded to improvement of the results in the surgical help delivery to the wounded persons, suffering MAT on the MES of the second level in delivery of medical help in conditions of the combat conflict on the East of the Ukraine.

Keywords

• military abdominal trauma; surgical help; antiterrorist operation.