Conceptual principles of the wounded combatants’ evacuation, suffering military surgical trauma on the medical support levels

Abstract

Objective. To improve the results of treatment of the wounded persons, suffering a combat surgical trauma, elaborating and introducing of objective scales of the trauma severity estimation into the medical evacuation system while conduction of Antiterroristic operation / Operation of Joint Forces.
 Materials and metods. Complex medical-statistical investigation was performed, in which 684 wounded persons, suffering a combat surgical trauma were included. Dynamical medical control and determination of the trauma severity degree in accordance to AdTS (Admission trauma Scale) were applied on all levels of medical support.
 Results. In the beginning of conduction of Antiterroristic operation / Operation of Joint Forces a mortallty have had occurred during transportation of wounded persons in unstable state (more than 9 points) to military-medical clinical centers. The wounded persons in a traumatic shock state were transported on forth level of medical support, what have been considered an organization defect in the help deliver process, which leaded to death of military persons. At the same time an unjustified delay of transportation of servicemen, suffering wounds of the wrist and foot (up to 5 points), on the first and second levels of medical support, leading to development of severe complications, have occurred. Taking into account the above mentioned, the authors have provided a differentiated approach for medical evacuation of wounded persons, suffering a combat surgical trauma, depending on its severity degree.
 Conclusion. Evacuation of wounded persons, suffering a combat surgical trauma, constitutes an integral part of the medical support system of Antiterroristic operation/Operation of Joint Forces, closely connected with a medical support process during transportation. Medical evacuation of wounded persons with injuries of the vision organ, the wrist and foot must be accomplished urgently to specialized clinic of the fourth level of medical support.

Endocrine dysfunction in the pathogenesis of combat surgical trauma and post-traumatic stress disorder (scientific review)

“…Сучасні воєнні дії створили унікальні проблеми для медичної, хірургічної та реабілітаційної допомоги військовозобов'язаним, які отримали поранення в бойових умовах [1][2][3][4][5][6]. Хоча сучасні досягнення в галузі медицини й хірургії призвели до значного покращення показників виживаності після тяжких травм, стратегії реабілітації постраждалих осіб повинні бути адаптовані до сучасних умов.…”

Treatment Tactics in Case of Infectious Complications in Patients with Combat Injuries of the Musculoskeletal System (according to the Clinic’s Own Experience)

“…Тому дуже бажано, щоб санація рани проводилася в межах перших 6 годин після поранення [1]. Окрім часового терміну, в який проводиться первинна хірургічна обробка рани, велике значення мають і якість та обсяг проведених заходів, логістика подальшого спостереження, діагностики та лікування, якість перев'язок та післяопераційного догляду, чітке розуміння плану лікувально-профілактичних заходів та послідовності евакуації пораненого і ще багато інших важливих факторів [2][3][4][5][6][7][8][9][10][11][12][13][14].…”