«Damage control» at severe polytrauma: neurosurgical aspects

Abstract

Purpose: to estimate results of «Damage control» principles application in surgical treatment of patients with traumatic intracranial hematomas at severe polytrauma.Materials and methods. In the research 43 patients were included aged in average (45.5±17.6) years, there were 36 men and 7 women. Wakefulness according to GCS was (6.2±1.4) points, state according to ISS scale — (54.3±8.2) points. As a comparison group we examined 41 injured persons, been treated using standard methods according to the Guidelines for Treatment of patients with Severe Traumatic Brain Injury (2007).Results. Intraoperative mortality in the main group was 7.3%, in the comparison group — 30%. Using «Damage control» principles reduced mortality in the main group — up to 60.9% that was significantly lower than group of comparison (92.5%) and mortality rate, estimated according to APACHE II scale (P<0,05).Conclusions. We have modified the technology «Damage control», which is applied for the treatment of 43 patients with severe concomitant traumatic brain injury. It is possible to improve the results of treatment.