ABSTRACT
It is important to improve the medical care system and treatment of victims, introduce new methods of treatment and attract the multidisciplinary specialists in the cases of multitrauma. An integrated approach is required for the identification of different character and severity of multiple craniofacial injuries and the development of rational surgical strategy on this base. Different scales such as AIS, CRIS, ISS, PTS, TRISS, TRISSCAN, CRAMS et.al, were created abroad. Another approach to medical strategy was developed in the department of military surgery of Kirov Military Academy in the late nineties. It was based on investigating of possibilities of surgical strategy optimization by application of objective evaluation of the severity of injuries (military surgery--SP, SG, SS). Given treatment strategy of victims with multiple craniofacial trauma resulted in double reduction of quantity of suppurative and septic complications (from 10.5% to 4.1%). It gave the possibility to reduce the lethality from 6.4% to 4.0%. At the same time a hospital stay was shortened and the strategy allowed obtaining satisfactory functional results of treatment and avoiding reinterventions for removal of posttraumatic facial deformations.
Subject(s)
Facial Injuries , Head Injuries, Penetrating , Osteomyelitis/prevention & control , Postoperative Complications/prevention & control , Skull Fractures , Video-Assisted Surgery , Adult , Endoscopy/adverse effects , Endoscopy/methods , Facial Injuries/diagnosis , Facial Injuries/mortality , Facial Injuries/surgery , Female , Fracture Fixation, Internal/adverse effects , Fracture Fixation, Internal/methods , Head Injuries, Penetrating/diagnosis , Head Injuries, Penetrating/mortality , Head Injuries, Penetrating/surgery , Humans , Intraoperative Neurophysiological Monitoring/methods , Male , Multiple Trauma/diagnosis , Multiple Trauma/mortality , Multiple Trauma/surgery , Osteomyelitis/etiology , Russia , Skull Fractures/diagnosis , Skull Fractures/mortality , Skull Fractures/surgery , Trauma Severity Indices , Treatment Outcome , Video-Assisted Surgery/adverse effects , Video-Assisted Surgery/methodsABSTRACT
Dynamics of mean value indices and mean dispersion doesn't exclude the feedback (Mayanskiy D.N., 2008) in process of study the disease according to cooperative processes using system leukocyte-monocyte-lymphocyte (L+M+LM). The authors investigated a dynamic balance between these cell substratums and collagen formation. Acute inflammatory processes in tissues of maxillofacial area accompanied by leukemoid response of peripheral blood in the form of leukocytosis (10 x 10(9)-15 x 10(9)/l and more). The authors completely agree with the opinion of M.M. Solov'yov (2012) and N.K. Artyushenko (2008) that mechanism of this reaction is associated with both the leukocyte redistribution in the inflammation zone and with changes of hematopoietic rostock which aimed to balance the affected compensatory mechanisms of nonspecific resistance.
Subject(s)
Cellulitis , Jaw Diseases , Leukocytes , Surgical Procedures, Operative/adverse effects , Surgical Wound Infection , Adult , Aged , Cellulitis/etiology , Cellulitis/immunology , Cellulitis/surgery , Female , Humans , Immunity, Cellular , Jaw Diseases/complications , Jaw Diseases/immunology , Jaw Diseases/surgery , Leukocyte Count , Male , Middle Aged , Prognosis , Reoperation/methods , Reoperation/statistics & numerical data , Risk Assessment , Risk Factors , Severity of Illness Index , Statistics as Topic , Surgical Procedures, Operative/methods , Surgical Wound Infection/immunology , Surgical Wound Infection/surgeryABSTRACT
Results of treatment of 186 patients treated in the clinic in the period from 2000 through 2005 for infectious complications after severe combined injuries who underwent 264 operations have been studied. It was established that the endovideosurgical method of sanitation of the infection focus was used in 50% of cases at an average. The investigation of surgical treatment of infectious complications in patients with severe surgical pathology has shown high efficiency of endovideosurgical method for treatment of such complications in the third period of wound dystrophy. The proposed endovideosurgical methods of sanitation of the infection focus have a number of advantages over open ones--low traumatism, less number of postoperative infectious complications, less duration of the postoperative period.
Subject(s)
Debridement/methods , Surgical Wound Infection/surgery , Video-Assisted Surgery/methods , Adult , Female , Follow-Up Studies , Humans , Male , Retrospective Studies , Treatment OutcomeABSTRACT
The article is devoted to the review of modern opinions concerning the experience of military operation medical support in conditions of local wars and military conflicts. On the base of analysis of medical assistance rendered to the wounded and casualties in Republic of Chechnya the advantages and defects of different approaches are discussed. The experience in rendering assistance to the casualties in the Armed Forces of NATO countries during the local wars for the last decades is discussed. It is shown that the optimal variant of organization of treatment-and-evacuation measures during the local armed conflicts and wars is the two-stage scheme of evacuation: the first medical aid--the qualified (specialized) medical aid.
Subject(s)
Transportation of Patients/standards , Warfare , Wounds and Injuries/therapy , First Aid/standards , First Aid/trends , Humans , Military Personnel , Russia , Transportation of Patients/trendsABSTRACT
Experimental studies making use of morphological and x-ray methods demonstrated that in comparison with control (filling of mandibular bone defects with blood clots) chonsuride, an animal polysaccharide, promoted earlier filling of postoperative bone cavities with connective tissue replacement of this tissue with coarse-fiber bone tissue. Secondary restructuring and mineralization of bone regenerate were enhanced as well.
