Lobanov GV*

Department of Traumatology, Orthopedics and HES, GOO VPO Donetsk NMU Named After M. Gorky, Donetsk, Ukraine

*Corresponding Author: Lobanov GV, Department of Traumatology, Orthopedics and HES, GOO VPO Donetsk NMU Named After M. Gorky, Donetsk, Ukraine.

Received: October 13, 2021; Published: November 23, 2021

Abstract

  Providing assistance to victims with polytrauma requires the development of modern approaches to diagnosis and treatment, both organizationally and tactically. Modern principles of care lead to the understanding that a thorough study of the victim's immune status, his metabolic response to trauma, is crucial for the possibility of preserving his life for a patient with polytrauma. The concept of "metabolic rehabilitation" has been developed, which is based on the following patterns: 1) in acute and early periods with polytrauma, cardiac activity and tissue oxygenation do not suffer from a decrease in erythrocyte counts to: erythrocytes 2.8, Hb 80, Ht 32%; 2) the principle of "permissible hypotension", blood pressure (100 mm Hg) Provides adequate tissue perfusion and reduces blood loss; 3) early minimally invasive surgery (external fixation of injuries of the musculoskeletal system using the concept of “separately controlled rod”); 4) operations are accompanied by early intensive therapy with long-term artificial ventilation of the lungs; 5) SIRS operations are excluded, with the exception of "rescue" operations. The main change in Damage Control Orthopedics is the approach to the patient with polytrauma from the standpoint of the balance of diagnostic manipulations with resuscitation. The system of therapeutic measures should include: a - a general complex for the elimination of the crisis state of the basic vital functions of the body and the correction of life support systems; b - directly measures to restore the anatomical structures and functions of damaged organs and segments, depending on the specific combination and nature of the damage.

Keywords: Polytrauma; Victims; Blood

References

1. Agadzhanyan VV., et al. “Polytrauma”. Novosibirsk: Nauka (2003): 494.
2. EK Humanenko., et al. “Clinical and pathogenetic substantiation of a new strategy and tactics for the treatment of severe concomitant injuries”. Materials of the XI Congress of Surgeons of the Russian Federation. Volgograd, (2011): 592-593.
3. Lobanov GV. “Diagnostics of the traumatic violation of the stability of the pelvic ring. Addition to the classification”. Zbirnik naukovikh prats spіvrobіtnikiv KMAPO im. P.L. Shupika, Kiev (2000): 252-255.
4. Sokolov VA. "Damage control is a modern concept of treatment of victims with critical polytrauma”. Bulletin of Traumatology and Orthopedics 1 (2005): 81-84.
5. Tania SSh. “Treatment of victims with severe concomitant injury”. Dr. med. Sciences – SPb (2015): 333.
6. Pfeifer R., et al. “DAMAGE CONTROL concept for polytrauma: what are the standards in 2021?”. Polytrauma 2 (2021): 10-18.
7. Roberts CS., et al. “Damage control orthopaedics evolving concepts in the treatment of patients who have sustained orthopaedic trauma”. Journal of Bone and Joint Surgery 2 (2005): 434-449
8. Volpin G., et al. “Damage control orthopaedics in polytraumatized patients - current concepts”. Journal of Clinical Orthopaedics and Trauma 1 (2020): 72-82.

Citation

Citation: Lobanov GV. “Diagnostics and Treatment of Polytrauma. Organizational and Tactical Aspects".Acta Scientific Orthopaedics 4.12 (2021): 29-33.

Copyright

Copyright: © 2021 Lobanov GV. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.