Mistakes and complications of wound treatment in children affected by earthquakes

The article presents the experience of organizational and therapeutic work as part of a mobile specialized pediatric surgical team during the period of liquidation of the medical consequences of devastating earthquakes. An analysis of the treatment of children with open bone fractures and soft tissue injuries at all stages of medical evacuation was carried out, the main causes of complications and adverse outcomes were diagnosed and identified. Special attention is paid to therapeutic, tactical and surgical errors, incorrectly performed operations and primary surgical treatment of wounds, which were carried out at the stage of inpatient treatment in children before the arrival of mobile specialized pediatric surgical team. In all cases, the errors presented were the direct causes of severe purulent-septic complications. The guideline of surgical treatment of complications and the features of management of this patient population are substantiated. The experience of treating children with complicated course of soft tissue injuries and open fractures indicates the need for complex, multi-stage operations under general anesthesia in most of the victims. A rational scheme of medical, organizational and advisory work in the general system of medical and sanitary provision for children in emergency situations, developed and consistently applied by mobile specialized pediatric surgical team specialists in practice, is presented, namely, the interaction of the hospital (the main hospital for the concentration and treatment of the children’s contingent) based with other medical institutions and hospitals where injured people were admitted and treated after the earthquake. children.