Pathophysiological substantiation of medical evacuation of the wounded persons, suffering injuries of the extremities on the levels of medical support

Хоменко, И. П.; Коrol, S. О.; Matviychuk, B. V.; Устінова, Л.А.

doi:10.26779/2522-1396.2019.06.25

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…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].…”

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

Hrytsai,

Poliachenko,

Tsokalo

et al. 2023

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Background. The successful treatment of combat wounds should be based on strict scientific principles, based not only on the time limits for successful wound healing, but also on the quality and scope of the measures taken, the logistics of follow-up, diagnosis and treatment, the quality of dressings and postoperative care, and a clear understanding of the treatment plan – preventive measures and sequence of evacuation of the wounded. Objective: to determine the scope and choice of optimal treatment tactics for combat injuries in patients during the war in Ukraine since 2014, who had infectious complications from the musculoskeletal system. Materials and Methods. The medical histories of patients who were treated with infectious complications at the clinic of bone-purulent surgery of the SI "Institute of Traumatology and Orthopedics of NAMS of Ukraine" from 2014 to mid2022 were analyzed. Results and Conclusions. The treatment of infectious complications of a combat injury is more intensive, protracted, and more costly in terms of resources and material. The plan covers staged treatment using various surgical procedures and techniques.

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Section: вступunclassified

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

Hrytsai,

Poliachenko,

Tsokalo

et al. 2023

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

Usenko,

Khomenko,

Kovalenko

et al. 2024

ЕМ

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The modern hostilities have created the unique challenges for medical, surgical and rehabilitation assistance to people liable for military service who have sustained injuries in the battle conditions. The experience of providing medical care for participants of modern military operations has shown that endocrine dysfunction is a leading pathogenetic link that affects the human body in combat surgical trauma and post-traumatic stress disorders. The main pathogenetic mechanism of trauma and post-traumatic stress disorders is associated with dysfunction of the hypothalamic-pituitary-adrenal axis. Hormones such as cortisol, dehydroepiandrosterone, adrenaline and noradrenaline are involved in the neuroendocrine mechanisms of stress development. These hormones regulate and control the stress response, reflecting the stages of its course and the adaptive capacities of the organism. Dysfunction of the hypothalamic-pituitary-thyroid axis has a significant importance in the regulation of both acute and chronic stress accompanied by the clinical development of various thyroid disorders such as hyperthyroidism, Graves’ disease, autoimmune thyroidopathies and nodular transformation. Therefore, the practical significance lies in the clinical studying the key indicators of pituitary-adrenal and pituitary-thyroid function, monitoring the function of the adrenal glands and the thyroid. Correction of these disorders, the treatment and rehabilitation of patients with combat-related traumatic injuries should be carried out with specialized endocrinological assistance. This approach will be relevant for military medicine in Ukraine in the following years.

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

Хоменко

Лурін

Коrol

et al. 2020

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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.

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Pathophysiological substantiation of medical evacuation of the wounded persons, suffering injuries of the extremities on the levels of medical support

Cited by 3 publications

References 11 publications

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

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

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

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

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