Herasymenko O. Clinical and organizational principles for the provision of surgical care and specialized treatment of wounded with combat abdominal trauma in the ATO conditions

The thesis is devoted to solving the urgent problem of modern military surgery – improving the results of treatment of a combat abdominal injury in an armed conflict based on the optimization of diagnostic and therapeutic measures at the levels of medical support. The widespread use of endovideosurgical technologies and dynamic laparoscopy at the II–III levels of medical care in the main group made it possible to avoid unnecessary traumatic interventions and to reduce the duration of inpatient treatment from 41,3±3,3 to 33,1±2,4 bed-days (p<0,05), to increase the percentage of the wounded returning to duty from 65,2 to 74,6 % (p<0,05). The use of interventional sonography and puncture-drainage interventions under ultrasound navigation, cell technologies (mesenchymal stem cells and platelet-rich plasma), endovideosurgical interventions with specialized treatment at the IV level of medical support led to a 1,4-fold reduction in the healing time of anterior abdominal wall defects, a decrease in the number of postoperative complications from 39,1 to 27,8 % (p<0,05). As a result of the application of the developed diagnostic and treatment program in the wounded with combat abdominal trauma, the number of trauma complications was reduced from 46,0 to 36,7 % (p<0,05). The overall mortality rate was reduced by 1,4 % (from 6,8 to 5,4 %), and with a dominant or competing abdominal injury – by 2,0 % (from 5,6 to 3,6 %).