FAST-PROTOCOL AND INTERVENTIONAL SONOGRAPHY IN THE DIAGNOSTIC AND TREATMENT OF COMBAT INJURIES OF THE ABDOMEN

  • I. P. Khomenko
  • K. R. Muradian
  • V. Yu. Shapoval
  • O. S. Herasymenko
  • Ya. I. Haida
  • A. Ju. Chertilina-Muradian
  • A. V. Okolets
Keywords: combat injuries of the abdomen, emergency sonography, interventional sonography.

Abstract

Summary. The aim — improvement of diagnostic and surgical treatment of wounded abdominal injuries by introducing emergency ultrasound techniques and mini-invasive surgery under the control of ultrasound imaging.

Materials and methods. A clinical and statistical analysis of the results of surgical treatment of 293 wounded with combat injuries of the abdomen who underwent treatment in military mobile hospitals was carried out. In the comparison of the wounded with combat injuries of the abdomen, additional diagnostic tests were carried out in the comparison groups — FAST protocol, puncture sanitation and draining surgical interventions under ultrasound navigation.

Results and discussion. In the main group, unlike the control group, all wounded were followed by the FAST protocol. Widespread introduction into the diagnostic program of FAST-protocol and diagnostic punctures under ultrasound navigation allows to reduce the level of more traumatic diagnostic laparocentheses from 24.7 to 2.2 % and unreasonable surgical interventions from 3.2 to 0.7 %. Based on the results of the study, we have developed an algorithm for diagnostic and therapeutic actions for the wounded with combat trauma to the abdomen according to the results of the FAST-protocol.

Conclusions. The data obtained indicate that the widespread adoption of the FAST protocol, transcutaneous puncture sanitation interventions under ultrasound guidance in the diagnosis and treatment of combat abdominal trauma and its complications contribute to a decrease in the number of invasive and more traumatic (often unreasonable) diagnostic and treatment methods, which leads to faster recovery and shortened treatment time.

References

1. Svitlychnyi EV, Hrechanyk OI. Ultrazvukova diahnostyka travmy ta yii uskladnen. K.: SPD Chaplynska N.V.,2016;215s. [In Ukr].
2. Khomenko IP, Svitlychnyi EV, Hrechanyk OI, Melnyk OM,. Tarasiuk BA, Muradian KR. Ekstreni ultrazvukovi doslidzhennia pry travmi FAST-protokol. Kyiv: Vydavnytstvo Liudmyla,2018;66s.[In Ukr].
3. Chestovich PJ, Browder TD, Morrissey SL, Fraser DR, Ingalls NK, Fildes JJ. Minimally invasive is maximally effective: diagnostic and therapeutic laparoscopy for penetrating abdominal injuries. J Trauma Acute Care Surg. 2015;78: 1076–1085. doi: 10.1097/TA.0000000000000655.
4. Smith IM. Scanning and war utility of FAST and CT in the assessment of battlefield abdominal trauma.Ann. Surg. 2014;P.1–8.
Published
2021-06-20
How to Cite
Khomenko, I. P., Muradian, K. R., Shapoval, V. Y., Herasymenko, O. S., Haida, Y. I., Chertilina-Muradian, A. J., & Okolets, A. V. (2021). FAST-PROTOCOL AND INTERVENTIONAL SONOGRAPHY IN THE DIAGNOSTIC AND TREATMENT OF COMBAT INJURIES OF THE ABDOMEN. Kharkiv Surgical School, (2), 116-120. https://doi.org/10.37699/2308-7005.2.2021.21
Section
QUESTIONS OF SURGICAL TREATMENT OF GUNSHOT WOUNDS

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