IMPROVEMENT OF SURGICAL CARE MANAGEMENT IN PATIENTS WITH CLOSED ABDOMINAL INJURY ABOARD THE NAVY SHIPS

The article includes an analysis of experience of surgical management in patients with closed abdominal injuries aboard the naval surface ships of the Navy of the USSR and the Russian Federation during long-distance voyages, and measures for improvement of surgical care management and treatment of the patients. It has been found that deaths because of wounds and closed abdominal injuries on the Soviet Navy ships were partly caused by late diagnosis, inaccurate assessment of the degree of blood loss, non-use of paracentesis at an advanced stage of care due to lack of surgical training of ship's doctors. To save positive results in future provision of surgical care to naval sailors during extended autonomous campaigns, there is needed an increase in the number of ship groups of specialized medical care (SGSMC) within the naval clinical hospitals of the fleets. This will allow to provide surgical care in a shorter time. An analysis of organization of surgical care of the Russian Navy ships personnel fulfilling tasks in the off-shore maritime zone and the ocean areas in 2012-2013 has shown the need for creation of additional 7 SGSMC: in the Northern Fleet - 2, in the Pacific Fleet - 2, in the Baltic fleet - 1, in the Black Sea Fleet - 1, in the Caspian Flotilla - 1. There has been proved the need to include staff anesthesiologists and paramedical anesthetists in these groups.

closed abdominal injury, intraabdominal hemorrhage, abdominal paracentesis, surgical care of patients during longdistance voyages