Fil A. The combined damage to the skeleton. Traumogenesis, causes of death, ways to improve the survival of victims in the prehospital and early hospital stage

Object: the traumatic process in patients with multiple trauma and skeletal injuries. Aim: to improve the survival rate of victims with multiple trauma and skeletal injuries in the prehospital and early hospital stages of medical care by making an evidence-based system of measures aimed at reducing the impact of causal factors for the lethal outcome of a traumatic process. Methods: clinical, laboratory, clinical expertise, histopathological, medical nonparametric statistics. The first clinical and epidemiological characteristics of traumatic process in patients with multiple trauma and skeletal injuries have been found. Scientific knowledge about the clinical and nosological characteristics of injuries of dead with multiple trauma and skeletal injuries was added. For the first time the influence of the skeletal component of multiple trauma on the traumatic process has been verified. Based on the analysis of the impact of effective clinical risk of death in victims with multiple trauma and skeletal injuries the direct causes of death of patients in this category have been shown for the first time. The first clinical and histopathological parallels of an appearance of the lethal outcome of the traumatic process were formed. The first the principle of clinical and pathophysiological consensus has been introduced in the process of formation of the program of treatment of patients with multiple trauma and skeletal injuries. The first emergency medical care in the prehospital and early hospital stages was formed and synchronized. This allowed scientific substantiate, develop and establish a system of measures for improve the survival rate of patients with multiple trauma and skeletal injuries. Due to the developed system it became possible to increase the survival rate of victims with multiple trauma and skeletal injuries on the prehospital and early hospital stages of medical care. Identifiable clinical productive risks of a lethal outcome allow clinicians to predict the occurrence of predictors of the mortality in victims with multiple trauma and skeletal injuries. Experimental clinical and histopathological parallels formed in different periods of the traumatic disease, provide an opportunity to significantly expand the knowledge of the traumatic process in patients with multiple injuries. The results of the study are introduced into clinical practice of City Community Hospital ambulance in Lviv, Kommunalnoi 8th city hospital in Lviv, the Clinical Hospital of the State Border Service in Lviv, Ternopil city municipal hospital emergency, Gorodetsky central district hospital, KU "Rivne regional clinical hospital", Vinnytsia city emergency hospital, the Sumy Oblast Children's clinical hospital, Belopol'skaya central district hospital. Traumatology and Orthopaedics.