Late complications of thoracoabdominal gunshot wounds. continuity of diagnosis and surgical treatment at the stage of specialized medical care in a multidisciplinary hospital

Thoracoabdominal wounds (TAW) are among the most difficult to diagnose and severe combined injuries. In the acute period of traumatic illness, traumatic shock and massive blood loss are the causes of death in injured patients. In the later (post-shock) period, at the stage of specialized medical care, mortality is caused by severe purulent and septic complications from the chest and abdominal organs, multiple organ failure, and metabolic disorders. The purpose of the study: based on a systematic analysis, to develop an algorithm for the continuity of diagnosis and surgical treatment of TAW complications, which ensures improved treatment outcomes for the wounded at the stage of specialized medical care in a multidisciplinary hospital. Material and methods. The results of surgical treatment of 104 patients with TAW from the area of the special military operation, who underwent 364 life-saving operations under the damage control program at the stage of qualified care, were analyzed. Results. At the stage of specialized care in a multidisciplinary hospital, the patients underwent 206 surgical interventions for purulent and septic complications. An algorithm has been developed for providing surgical care and early diagnosis of complications in the wounded after TAW. Conclusion. The use of modern diagnostic equipment and instrumental studies, performing endovideosurgical and minimally invasive procedures allowed all wounded to recover. Continuity in the treatment process between the military hospitals of the Ministry of Defense and the multidisciplinary hospitals of the Ministry of Health has improved the treatment outcomes of this severe category of patients.