[Medical tactics, approaches and complex treatment effectiveness in case of multiple trauma caused by a fall from a height]. / Vrachebnaya taktika, podkhody i effektivnost' kompleksnogo lecheniya postradavshego s politravmoi, poluchennoi pri padenii s vysoty.

OBJECTIVE: To demonstrate the approaches' implementation of specialized multidisciplinary and high-tech medical care in multistage complex treatment of patient with multiple trauma including combined severe trauma of the maxillofacial region such as minimally invasive surgical tactics with early and delayed osteosynthesis (e.g. selection of optimal surgical tactics within the periodization of traumatic disease concept). Moreover, the implementation of rational advanced intensive pathogenesis drug therapy with the prevention of infectious complications in cast of severe injuries. MATERIAL AND METHODS: The tactics, approaches and results of multistage complex specialized treatment of patient K., 56 years old who has got severe concomitant injuries to various areas of the body and extremities (including multiple maxillofacial trauma) after falling from a height are presented. CONCLUSION: Rational surgical tactics and the timely initiation (immediately after admission of the victim to 1st level trauma center) of pathogenesis intensive therapy with modern drugs and antibiotics contributed to the exclusion of infectious complications in the third period (the period of maximum likelihood of complications) of traumatic illness. Comprehensive treatment of a victim with multiple trauma based on the principles of specialized, multidisciplinary and high-tech medical care is able to provide a favorable clinical outcome - the recovery with the restoration of the damaged anatomical structures functionality and the absence of cosmetic defects.

[Applying the new conicotomy kit is the key to solve the problem of asphyxia at the prehospital stage]. / Primenenie novogo nabora dlya konikotomii ­ klyuch k resheniyu problemy asfiksii na dogospital'nom etape.

OBJECTIVE: The purpose of this study is to analyze the incidence of asphyxia, therapeutic measures, the outcomes of treatment of the wounded with impaired secure airway and to assess the effectiveness of the prototype: «one-time set to eliminate asphyxia (conicotomy)¼ UK-02 (state defense order LLC «NOVOPLAST-M¼). MATERIAL AND METHODS: The basis of the analysis was the material of 2047 case histories-clinical test data on armed conflicts of Military Field Surgery Department of the Military Medical Academy named after S. M. Kirov. Development and evaluation of the effectiveness of the prototype set of UK-02 to eliminate asphyxia in the course of experimental studies was carried out on 6 biological objects (pigs). RESULTS: The incidence of asphyxia is 1.5% according to national data and 8-13% according to the results of studies by foreign authors. CONCLUSION: Complete and service equipment-a one-time set of UK-02 (to eliminate asphyxia (conicotomy) will reduce prehospital mortality and significantly improve the outcomes of treatment of the wounded with severe damage to organs and tissues of the maxillofacial region, ENT organs and pathological processes accompanied by impaired secure airway.

[Comprehensive treatment of a victim with gunshot injury of the head complicated by infection]. / Kompleksnoe lechenie postradavshego s infektsionno oslozhnennym ognestrel'nym povrezhdeniem golovy. Vybor effektivnoi taktiki lecheniya.

Gunshot head injuries make up 35% of all injuries. Brain injuries are diagnosed in 42.2% of cases, maxillofacial region - 35.7%, eye - 13.9%, outer and inner ear - 3.2%. These damages account 14.8%, 12.5%, 4.9% and 2.9% of the total number of injuries, respectively. In our opinion, primary surgical treatment of gunshot wounds should be carried out in a strict system of multiple-stage surgical management in accordance with the principles of treating wounds from high-speed weapons.

MODERN ANTICEPTIC HYDROGEL IN TREATMENT OF INFECTIOUS COMPLICATIONS OF WOUNDS IN SURGERY.

Treatment and prevention of infectious complications remain the actual problems of surgery. Purulent complications very often arise in operative interventions with an application of various fixing devices. A study of the adhesive surgical antiseptic (ASA) «ARGAKOL¼ (Registration certificate № FS 012б2005/1878-05) was completed. The results of the preliminary antimicrobial activity of the developed composition showed that ASA «ARGAKOL¼ had a broad spectrum of antimicrobial action. There was used the method of twofold serial dilutions in a liquid medium and Cup-suspension. The study of the influence of the ASA «ARGAKOL¼ on the wound healing was made in the experiment on white outbred rats. There were carried out two series of experiments with 10 rats in each group: on the model of just contaminated wound (the first series) and on the model of infected wound with delayed application of the glue (after 3 days) after trauma (the second series).