title: [The staged surgical treatment of the injured persons with severe closed combined abdominal trauma].
abstract: In 91 injured persons, suffering severe closed combined abdominal trauma, the staged surgical treatment was conducted, in 41 of them the operation was performed during one narcosis, but with surgical pause after temporary stopping of hemorrhage, in 50 the "damage control surgery" was applied. Unstable critical state of the injured persons, "unfavorable" prognosis of course of an acute period of the traumatic disease served as indications for the staged surgical treatment conduction. While the urgent laparotomy performance the surgical manipulations were conducted in minimal volume, surgical pause was applied with the patient's state reestimation. Operative intervention was restarted when a stable hemodynamics and the homeostasis indices improvement were achieved. Middle value of surgical pause have constituted (94.5 +/- 7.2) min. In 50 injured persons, regardless of the hemorrhage stopping and stabilization of systolic arterial pressure, the hemostasis indices were disordered, they were admitted to department of reanimation and intensive therapy with consequent conduction of programmed relaparotomy (the technology of "damage control surgery"). Application of differentiated staged surgical treatment in the injured persons, suffering severe closed combined abdominal trauma, have permitted to reduce the occurrence rate of decompensated shock--by 6.4%, the syndrome of disseminated intravascular coagulation--up to 1%, polyorgan insufficiency--up to 7.1%, general lethality--by 9.5%.
authors: Ia L
authors: IaL
authors: Zaruts'kyĭ
authors: I R
authors: IR
authors: Trutiak
mesh_terms: D000007:Abdominal Injuries / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D009104:Multiple Trauma / Q000503:physiopathology / Q000601:surgery*; D013514:Surgical Procedures, Operative / Q000379:methods; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult