Surgical treatment of abdominal injuries with combined trauma and polytrauma: a comparative analysis of the structure and components of the abdominal intervention phase (message two)

Abstract

Introduction. Blunt abdominal trauma is recognized as one of the leading causes of preventable death among people of working age. In Ukraine, the system of anatomical and functional prediction of the course of trauma, which determines the time, volume, and sequence of surgical interventions for each specific casualty, is considered to be the most advanced technology for the treatment of polytrauma in general, and particularly of combined thoracoabdominal trauma. Aim. To research treatment tactics in patients with combined thoracoabdominal trauma through a retrospective expert analysis of the content of abdominal surgery for treatment of abdominal injuries. Materials and methods. Through a retrospective expert analysis of the operative techniques used to address abdominal injuries in 2009 patients with combined thoracoabdominal trauma, we identified 21 key components of the abdominal intervention. These techniques were applied in 306 (15.2%) abdominal surgeries, which ranged from exploratory laparotomies to various resection procedures. Results. It was found that 72 (23.5%) of the laparotomies were performed on an exploratory basis. No instances of nonoperative management of solid organs injuries or damage control procedures were observed. A comparative analysis of the distribution of surgical components between patients with combined thoracoabdominal trauma and those with polytrauma revealed a high level of consistency, with a statistically significant difference (p < 0.01). Conclusions. Thus, within the broader clinical context, the system of anatomical and functional prediction played a crucial role in determining the approach for treating abdominal injuries in patients with polytrauma. The optimization of surgical management for abdominal injuries in combined