Burluka V. Surgical treatment of patients with polytrauma and unstable damages of pelvis

The dissertation is devoted to the improvement of the results of surgical treatment of patients with combined damage to the pelvic area with an unstable pelvic ring in the polytrauma with the development, justification and implementation of the system for providing surgical care based on the severity of injury, prediction of clinical course, modern methods of diagnosis and differential surgical tactics in different periods of traumatic disease. Pathogenetically grounded system of differential surgical treatment of patients suffering from polytrauma and unstable pelvic ring depending on the severity of trauma in acute period of traumatic disease with the allocation of minimal, brief and complete volume of surgical interventions in case of damage to pelvic and outside of pelvic localization. Proposed blocks of the sequence diagram of operations in hemodynamically unstable patients. On the basis of the study of changes in homeostasis indices, depending on the severity of the injury and the prognosis of the traumatic disease, the time frame for performing operations for stabilization of the pelvic bones is justified. The principles of operating the treatment of pelvic ring injuries in patients in ІІ, ІІІ, ІV periods of traumatic disease are formulated. It has been scientifically proved that internal or combined osteosynthesis of an unstable pelvic ring in patients suffering from polytrauma and damage to the pelvic organs (excluding the rectum) is possible, provided timely and adequately performing drainage operations in the acute period of traumatic disease. The efficiency of using the proposed system for providing surgical care is proved on the basis of analysis of functional results of treatment, complications, and lethality.