Abstract
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