Surgical care to the wounded with large bowel battle truma during the anti-terrorist operation
Keywordsgunshot wound, large bowel, “damage control surgery”, “second look”
A study of surgical treatment at the stages of medical evacuation of 83 wounded with a battle trauma to the abdomen and damage to the large bowel, received during the anti-terrorist operation. The wounded patients were divided into two groups: the comparison group — 42 patients with a traditional surgical management, and the main group — 41 patients with a priority surgical management, which depended on the severity of the condition, the severity of internal injuries and operational and tactical circumstances. At the second level of medical care, the surgical management and the extent of surgical interventions were determined: full, abbreviated or damage control surgery. At the III–IV levels of medical care, planned repeated operations “damage control surgery”, “second look”, as well as comprehensive treatment of the consequences and complications of gunshot wounds were performed.
A new approach to the choice of surgical management, as well as the standardization of the estent of surgical interventions have reduced the number of postoperative abdominal complications by 27% and mortality rate — by 16.4%.
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