The purpose of the study. Is to analyze the medical and social consequences of pelvic fractures in combination with polysegmental injuries, study the health care system for these injuries, predict complications and mortality to assess the quality of life of patients with pelvic fractures and other segments (lower or upper limb). Materials and methods. The examination reports were examined according to the Zaporizhia Regional Trauma expertise commission code ICD-10 codes/manual S32 (Fracture of the lumbar spine and pelvic bones). Results. According to the Zaporizhia Regional Trauma expertise commission, the number of patients after bone fractures in 2014–2018 is 44 people. The analysis of the material revealed the general tendencies of steady growth of the number of patients with pelvic trauma to disability, which confirms the world statistics. During the period 2016–2019 on the basis of «Сity hospital of emergency medical care» and «City Hospital № 9» were operated on 28 patients with fractures of the acetabulum, of which as a result of osteoarthritis of the hip joint surgery was performed in 3 cases (10, 7%). Conclusions. Some methods of trauma care need to be improved, aimed at reducing their trauma, as well as preventive measures for the development of general and local complications in victims with combined pelvic trauma, refusal of surgical treatment entails improper fracture fusion and disability Keywords: polytrauma, disability, temporary disability, polysegmental injuries, quality of life.
Purpose of the study. Develop schemes for infusion therapy of sepsis with purulent complications of fractures of the foot bones in patients with diabetes mellitus. In order to restore disorders of homeostasis, patients received a complex of medical measures including surgical treatment, infusion therapy, immunotherapy, antibiotic therapy. The results of treatment of 22 diabetic patients with foot injuries that were complicated by purulent-inflammatory process and sepsis were studied. The patients were under the constant control of the endocrinologist. The use of the developed medical tactics allowed improving the results of treatment of patients with diabetes with traumatic sepsis. Keywords: sepsis, multiple organ failure, surgery, infusion therapy.
Summary. Introduction Every year, 18–20 million cases of sepsis are recorded in the world, 30 % of which result in death. Hopes that with the development of sanitary-hygienic measures the dynamics of sepsis will decrease, turned out to be illusory. The annual increase in the frequency of sepsis is 8.7 %, while it is noted that the number of patients with impaired carbohydrate metabolism increases by 8-27 %. Materials and methods. 5612 case histories of patients with purulent-septic diseases who were treated at the center for the period 2015-2019 were analyzed. Results. It was found that 213 (3.8 %) patients had diabetes mellitus (DM) type I or II (group 1), and the number of patients with complicated diabetic foot syndrome (SDS) was 43.3 % of the total number of patients (2431 patients) — 2 group. The development of sepsis in patients of the 1st group was recorded in 1.4 % of cases (46 patients), while in patients with complicated SDS — in 8.3 % (202 patients). Among the latter, in the overwhelming majority of cases, the starting point in the development of sepsis was “wet” gangrene of the lower extremities. Conclusions. In patients with diabetes, the risk of developing septic complications is significantly higher than in patients without impaired carbohydrate metabolism.
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