scholarly journals THE ROLE AND PLACE OF DAMAGE CONTROL SURGERY IN MILITARY MEDICAL EVACUATION DOCTRINE DURING HOSTILITIES IN MODERN WAR

2021 ◽  
Vol 65 (2) ◽  
Author(s):  
Ihor Trutiak ◽  
◽  
Volodymyr Pivnyk ◽  
Hryhorii Prokhorenko ◽  
Nazar Kalynovych ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Medical Care ◽  
Surgical Procedures ◽  
Damage Control ◽  
Military Hospital ◽  
Surgical Trauma ◽  
Main Task ◽  
Control Technology ◽  
Injured Patients ◽  
Temporary Closure

Introduction: The severity of the combined injury, traumatic shock, blood loss and traumatic prolonged primary surgery are the cause of high mortality injured patients. In civilian medicine, damage control technology is widely used to treat patients with severe polytrauma, which has improved the survival of this group of patients. Objective: Analyze the effectiveness of using "damage control" technology in wounded with polytrauma at the second level of medical care during war conflict in Eastern Ukraine and organization of combat casualty care. Methods: Medical and statistical analysis of the effectiveness medical treatment for patients combat-ralated injuried and polytrauma performed on the basis of a mobile military hospital during 2015-2019 period. Results: In 660 patients with combat multiple and combined injuries and in 1027 - with severe military combined trauma, medical tratment was provide by "damage control" technology. The main task of the first stage of surgery intervention was to stop the bleeding and stabilize the patient condition. 130 patients with intra-abdominal bleeding underwent laparotomy, temporary stop of bleeding, blood sampling for autotransfusion and temporary closure of the abdominal cavity. For the purpose of temporary hemostasis in 15 patients abdominal tamponade was performed, in 26 - liver tamponade, in 24 - splenectomy, in 6 - nephrectomy and in 6 - put the clamps were applied to bleeding vessels. In 14% injured patients definitive stage of surgical procedures were performed at the second level of medical care on the background of abdominal compartment syndrome in 10, visceral edema in 14 and peritonitis in 40 patients. Conclusions: Providing emergency medical treatment, surgical procedures and intensive care at the second level of medical tretment using the technology of "damage control" and timely patients evacuation are the key to reducing mortality and complications of military surgical trauma

The development of health care in Siberia in the 18th — first half of the 19th century

2019 ◽  
Vol 5 (2) ◽  
pp. 121-132
Author(s):  
Ekaterina V. Shulyak
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Political Development ◽  
Medical Personnel ◽  
Military Hospital ◽  
Genetic Method ◽  
Industrial Enterprises ◽  
Medical Institutions ◽  
Russian State ◽  
Folk Remedies

Development of health care of Siberia in the 18<sup>th</sup>&nbsp;— first half of the 19<sup>th</sup> century was closely connected with economic and political development of the Russian state. Before the medical personnel emergence in Siberia its population received medication only in the form of folk remedies. Development of its territory, insanitary conditions of life of Siberians, constant contingent of exiled to the indigenous people, and severe climate contributed to the spread of such diseases as smallpox, syphilis, and others.<br> The first medical institutions of Siberia were military hospital and infirmaries. In the days of reign of the Empress Anna Ioannovna, the city medical care started developing, and thanks to an initiative of the industrial enterprises owners&nbsp;— medical care for miners. After the establishment of the Public Charity Orders in Siberia, hospitals under their jurisdiction began to function in Tobolsk, Irkutsk, and Tomsk. A worthy contribution to the development of local medical institutions was made by donators Tolstopyatov, Bednyagin, Chupalov, and others. However, deficiency of financing, hospitals, and the medical personnel couldn’t adequately satisfy the needs of Siberian inhabitants in medical care.<br> The purpose of the article is to analyse the condition of public health, causes of morbidity and mortality of the population, as well as the process of medical care development in Siberia the turn of the 18<sup>th</sup> century by means of a historical and genetic method.

scholarly journals Simultaneous Casualty Admissions—Do they Affect Treatment in the Receiving Trauma Center?

2021 ◽  
Author(s):  
Michel Paul Johan Teuben ◽  
Carsten Mand ◽  
Laura Moosdorf ◽  
Kai Sprengel ◽  
Alba Shehu ◽  
...  
Keyword(s):  
Injury Severity ◽  
Damage Control ◽  
Ct Scanning ◽  
Mortality Rates ◽  
Trauma Centers ◽  
Simultaneous Treatment ◽  
Diagnostic Pathway ◽  
Injured Patients ◽  
The Impact ◽  
Mean Time

Abstract Background Simultaneous trauma admissions expose medical professionals to increased workload. The impact of simultaneous trauma admissions on hospital allocation, therapy, and outcome is currently unclear. We hypothesized that multiple admission-scenarios impact the diagnostic pathway and outcome. Methods The TraumaRegister DGU® was utilized. Patients admitted between 2002–2015 with an ISS ≥ 9, treated with ATLS®- algorithms were included. Group ´IND´ included individual admissions, two individuals that were admitted within 60 min of each other were selected for group ´MULT´. Patients admitted within 10 min were considered as simultaneous (´SIM´) admissions. We compared patient and trauma characteristics, treatment, and outcomes between both groups. Results 132,382 admissions were included, and 4,462/3.4% MULTiple admissions were found. The SIM-group contained 1,686/1.3% patients. The overall median injury severity score was 17 and a mean age of 48 years was found. MULT patients were more frequently admitted to level-one trauma centers (68%) than individual trauma admissions were (58%, p < 0.001). Mean time to CT-scanning (24 vs. 26/28 min) was longer in MULT / SIM patients compared to individual admissions. No differences in utilization of damage control principles were seen. Moreover, mortality rates did not differ between the groups (13.1% in regular admissions and 11.4%/10,6% in MULT/SIM patients). Conclusion This study demonstrates that simultaneous treatment of injured patients is rare. Individuals treated in parallel with other patients were more often admitted to level-one trauma centers compared with individual patients. Although diagnostics take longer, treatment principles and mortality are equal in individual admissions and simultaneously admitted patients. More studies are required to optimize health care under these conditions.

Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis

1993 ◽  
Vol 28 (4) ◽  
pp. 838 ◽  
Author(s):  
Germano Mwabu ◽  
Martha Ainsworth ◽  
Andrew Nyamete
Keyword(s):  
Medical Treatment ◽  
Medical Care ◽  
Empirical Analysis ◽  
Quality Of Medical Care

scholarly journals Factors associated with using the internet for medical information based on the doctor-patient trust model: a cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yang Fu ◽  
Tianwei Tang ◽  
Junhao Long ◽  
Bohuai Lin ◽  
Jiayue Li ◽  
...  
Keyword(s):  
Medical Treatment ◽  
Medical Care ◽  
Medical Information ◽  
Cross Sectional Study ◽  
Behavioural Intention ◽  
Total Effect ◽  
Patient Trust ◽  
Cross Sectional ◽  
Factors Associated ◽  
Personal Trust

Abstract Background Internet medical care has been advancing steadily, especially during the coronavirus disease 2019 pandemic, the development momentum of Internet medical care in China is more vigorous. This study aimed to explore the factors associated with using the Internet for medical information, to examine the popularisation and implementation of Internet medical treatment and feasible strategies, and promote the further development of Internet medical treatment. Methods A cross-sectional study was conducted on 408 medical patients who had used online medical services. The one-way analysis of variance or independent samples t-test was used to compare the differences in the influence of demographic characteristics on behavioural intentions of different people seeking medical care. Pearson’s correlation was used to evaluate the correlation between different measurement variables. A mediation regression analysis was used to explore the mediating role of trust in Internet medical care. Results The difference in the influence of Internet medical use frequency on the behavioural intention of different participants was statistically significant (F = 3.311, P = 0.038). Among the influencing factors, personal trust propensity (r = 0.387, P < 0.01), website credibility (r = 0.662, P < 0.01), hospital credibility (r = 0.629, P < 0.01), doctor’s credibility (r = 0.746, P < 0.01), and online patient trust (r = 0.874, P < 0.01) were positively correlated with patients’ behavioural intentions. In the analysis of intermediary factors, the total effect of the credibility of the diagnosis and treatment website on the behavioural intention of patients was 0.344. The total effect of the credibility of the diagnosis and treatment hospital on the behavioural intention of patients was 0.312; the total effect of the service doctor’s credibility on the patient’s behavioural intention was 0.385; the total effect of the personal trust tendency on the patient’s behavioural intention was 0.296. Conclusions This study found defects in various factors that produce distrust in Internet medical treatment. It also reveals the positive effect of trust factors on the development and implementation of Internet medical treatment and provides some ideas for improving the use of Internet medical treatment by the masses.

scholarly journals A Novel Technique for the Damage Control of Huge Diaphragmatic Injuries

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Boris Kessel
Keyword(s):  
Primary Closure ◽  
Damage Control ◽  
New Technique ◽  
Primary Suture ◽  
Novel Technique ◽  
Control Setting ◽  
Animal Trial ◽  
Temporary Closure

A novel technique for the damage control of big diaphragmatic injuriesPurpose: To evaluate and describe a novel technique for the temporary closure ofmajor diaphragmatic defects not suitable for primary suture in damage control setting.Background: It is an acceptable opinion that all left sided diaphragmatic injuriesshould be repaired, as opposed to right sided where the liver may safely protect thedefect. In most cases the repair of the diaphragm is simple, using non-absorbablesutures. Closure of defects not suitable for primary suture, remains a reallychallenging problem. Up today, there is no adequate solution for prevention of re-protrusion of abdominal contents in a damage control setting.Methods: We report a novel technique suitable for treating diaphragmatic injuries indamage control setting. This method allows a rapid temporary closure of, non-suitablefor primary closure, large diaphragmatic defects and part of the damage controlconcept.Results: Two anesthetized pigs were used in an animal trial to evaluate the feasibilityof the technique. Same size defects were created in both subjects. In the first subject,the defect was closed with a plastic (Bogota) bag. In the second subject, thediaphragmatic defect was covered using a large abdominal pad. In both cases, nochest protrusion was observed after completion of the experiment.Conclusion: We describe a simple new technique for temporary diaphragmatic closurethat might be done as part of damage control. Further investigation will help toinclude it to routine surgical arsenal.

scholarly journals Damage control surgery in the abdomen: An approach for the management of severe injured patients

2008 ◽  
Vol 6 (3) ◽  
pp. 246-252 ◽  
Author(s):  
Stylianos Germanos ◽  
Stavros Gourgiotis ◽  
Constantinos Villias ◽  
Marco Bertucci ◽  
Nikitas Dimopoulos ◽  
...  
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Injured Patients

Delayed Primary Closure in Damage Control Laparotomy: The Value of the Wittmann Patch

2007 ◽  
Vol 73 (1) ◽  
pp. 10-12 ◽  
Author(s):  
Josef G. Hadeed ◽  
Gregory W. Staman ◽  
Hector S. Sariol ◽  
Sanjay Kumar ◽  
Steven E. Ross
Keyword(s):  
Primary Closure ◽  
Damage Control ◽  
Trauma Surgery ◽  
High Rate ◽  
Damage Control Laparotomy ◽  
Abdominal Closure ◽  
Delayed Primary Closure ◽  
Accepted Practice ◽  
Planned Relaparotomy ◽  
Temporary Closure

Damage control laparotomy has become an accepted practice in trauma surgery. A number of methods leading to delayed primary closure of the abdomen have been advocated; complications are recognized with all these methods. The approach to staged repair using the Wittmann patch (Star Surgical Inc., Burlington, WI) combines the advantages of planned relaparotomy and open management, while minimizing the rate of complications. The authors hypothesized that use of the Wittmann patch would lead to a high rate of delayed primary closure of the abdomen. The patch consists of two sheets sutured to the abdominal fascia, providing for temporary closure. Advancement of the patch and abdominal exploration can be done at bedside. When the fascial edges can be reapproximated without tension, abdominal closure is performed. Twenty-six patients underwent staged abdominal closure during the study period. All were initially managed with intravenous bag closure. Eighty-three per cent (20 of 24) went on to delayed primary closure of the abdomen, with a mean time of 13.1 days from patch placement to delayed primary closure. The rate of closure using the Wittmann patch is equivalent to other commonly used methods and should be considered when managing patients with abdominal compartment syndrome or severe abdominal trauma.

Damage Control for Thoracic Trauma

2014 ◽  
Vol 80 (9) ◽  
pp. 910-913 ◽  
Author(s):  
Michael J. Mackowski ◽  
Rebecca E. Barnett ◽  
Brian G. Harbrecht ◽  
Keith R. Miller ◽  
Glen A. Franklin ◽  
...  
Keyword(s):  
Thoracic Trauma ◽  
Injury Severity ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Control Techniques ◽  
Transfusion Requirements ◽  
University Of Louisville ◽  
Level I ◽  
Temporary Closure ◽  
Complications And Mortality

Damage control surgery involves an abbreviated operation followed by resuscitation with planned re-exploration. Damage control techniques can be used in thoracic trauma but has been infrequently reported. Our goal is to describe our experience with the use of damage control techniques in treating thoracic trauma. A retrospective analysis of all patients undergoing damage control thoracic surgery related to trauma from January 1, 2010, to January 1, 2013, at University of Louisville Hospital, a Level I trauma center. Variables studied included injury characteristics, Injury Severity Score, surgery performed, duration of packing, length of stay (LOS), ventilator days, transfusion requirements, complications, and mortality. Twenty-five patients underwent damage control surgery in the chest with packing, temporary closure, and planned re-exploration after stabilization. Seventeen patients underwent anterolateral thoracotomy, and eight patients underwent sternotomy. The mean LOS and duration of temporary packing was 20.6 and 1.4 days in the thoracotomy group, respectively, and 19.5 and 1 day in the sternotomy group, respectively. The overall mortality rate was 40 per cent, 35 per cent in the thoracotomy group and 50 per cent in the sternotomy group. Like in severe abdominal trauma, damage control techniques can be used in the management of severe thoracic injuries with acceptable results.

Alternative Surgeries for Vertigo in Meniere's Disease

1995 ◽  
Vol 112 (5) ◽  
pp. P44-P44
Author(s):  
Dirk Hoehmann ◽  
John L. Dornhoffer
Keyword(s):  
Medical Treatment ◽  
Surgical Procedures ◽  
Meniere’S Disease ◽  
Vestibular Nerve ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Educational objectives: To find a straightforward strategy in dealing with vertigo in patients with Meniere's disease who failed medical treatment, and to be familiar with fine points of surgical procedures, including endolymphatic sac surgery, cochleostomy, vestibular nerve sections, and labyrinthectomy.

scholarly journals Comparative study of abdominal cavity temporary closure techniques for damage control

2016 ◽  
Vol 43 (5) ◽  
pp. 368-373 ◽  
Author(s):  
MARCELO A. F. RIBEIRO JR ◽  
EMILY ALVES BARROS ◽  
SABRINA MARQUES DE CARVALHO ◽  
VINICIUS PEREIRA NASCIMENTO ◽  
JOSÉ CRUVINEL NETO ◽  
...  
Keyword(s):  
Damage Control ◽  
Low Cost ◽  
Abdominal Cavity ◽  
Damage Control Surgery ◽  
Cellular Level ◽  
Easy Access ◽  
Vacuum Assisted Closure ◽  
Temporary Closure ◽  
Reducing Stress ◽  
Vacuum Assisted Closure Therapy

ABSTRACT The damage control surgery, with emphasis on laparostomy, usually results in shrinkage of the aponeurosis and loss of the ability to close the abdominal wall, leading to the formation of ventral incisional hernias. Currently, various techniques offer greater chances of closing the abdominal cavity with less tension. Thus, this study aims to evaluate three temporary closure techniques of the abdominal cavity: the Vacuum-Assisted Closure Therapy - VAC, the Bogotá Bag and the Vacuum-pack. We conducted a systematic review of the literature, selecting 28 articles published in the last 20 years. The techniques of the bag Bogotá and Vacuum-pack had the advantage of easy access to the material in most centers and low cost, contrary to VAC, which, besides presenting high cost, is not available in most hospitals. On the other hand, the VAC technique was more effective in reducing stress at the edges of lesions, removing stagnant fluids and waste, in addition to acting at the cellular level by increasing proliferation and cell division rates, and showed the highest rates of primary closure of the abdominal cavity.

Sign in / Sign up

Export Citation Format

Share Document