MANAGEMENT TACTICS FOR SUFFERERS WITH POLYTRAUMA IN ACUTE PERIOD OF TRAUMATIC DISEASE

Aim. To develop the management tactics used in the struggle for life during the acute period of traumatic disease in sufferers with multiple long bone fractures, which are characterized by shock, external and internal hemorrhage, fat embolism. Materials and methods. The study involved 156 patients with polytrauma over the period of 2009-2013. Three groups of patients, who experienced different ways of rendering intensive therapy at the prehospital and hospital stages, were formed. Results. Sufferers with multiple and combined injuries of musculoskeletal system (MSS) who underwent surgical intervention in the acute traumatic period improved their health faster than those who underwent surgery in the late traumatic period, that was confirmed by the basic hemodynamic indices ( p < 0,05). Surgical techniques during the first day after the injury, which were applied for all types injuries, both abdominal and orthopedic (ISS < 25 scores), promoted stabilization of patients’ health status and were antishock measures. With introduction of new approaches for the treatment of traumatic disease in the acute period, the terms of staying at the resuscitation and intensive therapy units reduced from 2,98 to 1,86 days and at the profile traumatological unit from 13,12 to 11,78 days. Conclusions. Introduction of a new antishock algorithm permitted to perform surgeries in sufferers with polytrauma not only by vital indices, but to use early surgical tactics for management of patients with multiple and combined MSS injuries.

Polytrauma, acute period of traumatic disease, prehospital and hospital stage