[Organization of treating patients with major vessel injuries at stages of evacuation].
Khirurgiia · 2003-01-01 · Observational study
Abstract
The experience in treatment of 236 patients with primary injuries of major vessels is presented. A pressure dressing and tense surgical pack of the wound were used in a prehospital treatment. Use of a hemostatic tourniquet (37.3%) led to increased ischemia of injured extremity tissues. Maximal shortening of evacuation time is another important factor. Time to qualified surgical care was 3.2 +/- 0.4 hrs from injury moment, specialized--5.5 +/- 0.7 hrs. Shock was seen in 94.9% wounded. It is necessary to begin anti-shock treatment immediately after injury. Surgery was started only after shock compensation. If shock was caused by continued bleeding, surgery was started at the same time with anti-shock treatment (5.7%). Temporary shunt was used in field conditions in 35.9% wounded. In 11 (19.7%) cases endoprosthesis of original construction (two-lumen tube with microirrigator) was used. If this device was used there were no cases of arterial or venous thrombosis at the stage of specialized treatment. Since using of temporary endoprosthesis leads to delay of evacuation for specialized care it was performed only in cases of gangrene's threat when arrest of bleeding could not be performed with other methods.