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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_970_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Contents
- •Reference
- •Preface
- •The Editors
- •List of Contributors
- •Introduction
- •What Makes Conflict or Disaster Surgery Different?
- •Humanitarian or Conflict Response Categories
- •Laws of Conflict
- •Am I Ready for Deployment Within a Resource-Limited Environment?
- •2. Patterns of Injury
- •Contents
- •Energy Release Processes
- •Bombs
- •Projectile Injury
- •Knives (and Fragments)
- •Blast Effects on the Human Body
- •Echelons and Roles of Medical Support
- •Evacuation Chain Between Roles or Echelons of Care
- •Blast Effects in Vehicles
- •Blunt Impact
- •Burns
- •Deliberate Acts
- •Domestic Explosions
- •Industrial Activity and Explosive Storage
- •The Natural World
- •The Effect of High-Strain Rate on Biological Materials
- •Bone
- •Skin
- •Conclusion
- •Acknowledgements
- •Further Reading
- •3. Damage Control Resuscitation
- •Damage Control Resuscitation (DCR) in Resource-Limited Environment
- •Haemostatic Resuscitation
- •Damage Control Surgery
- •Monitoring
- •Further Reading
- •Haemorrhage
- •Treatment Options in the Prehospital Arena
- •Whole Blood
- •Packed Red Blood Cells
- •Plasma
- •Crystalloids
- •Colloids
- •Tranexamic Acid
- •How Do I Stop Thinking About the Future and Treat the Patient Now?
- •Whenever Shock is Diagnosed, Administer Tranexamic Acid (TXA)
- •Key Points
- •Further Reading
- •5. Point-of-Care Ultrasound
- •Introduction
- •Resource Limitation Concern
- •Brief Review of Material
- •Resource-Limited Environment Pocus
- •E-Fast
- •How to Perform the Exam
- •RUSH (Rapid Ultrasound for Shock)
- •Pump Evaluation
- •Tank Evaluation
- •Pipe Evaluation
- •Optic Nerve Sheath Diameter (ONSD)
- •Other POCUS Range in the Resource-Limited Environment
- •Ten Resource-Limited Environment POCUS Key Points
- •Further Reading
- •6. Thoracic Injury Management
- •Introduction
- •Left Anterolateral Thoracotomy
- •Clamshell Thoracotomy
- •Cardiac Injuries
- •Hilar Injuries
- •Pulmonary Injuries
- •Posterior Mediastinal Injuries
- •Aortic Control
- •Tracheobronchial Injury
- •Oesophageal Injury
- •Combined Tracheobronchial Injuries
- •Clamshell Thoracotomy and Exposure of Arch Vessels
- •Closure and Drains
- •Anterolateral Thoracotomy
- •Clamshell
- •Additional Reading
- •Focal Repairs
- •7. Junctional and Extremity Vascular Trauma
- •Epidemiology
- •Presentation and Initial Workup
- •Pathology
- •Considerations for Vascular Surgery in Austere Conditions
- •Priorities in the Multiply Injured Patient
- •Injury Diagnosis and Imaging
- •Surgical Equipment and Supplies
- •Orthopaedic Injury
- •Vascular Damage Control
- •Vein Injury Management
- •Fasciotomy
- •Postoperative Assessment and Monitoring
- •General Vascular Reconstruction Techniques
- •Vascular Control
- •Injury Exposure
- •Thrombectomy and Anticoagulation
- •Interposition and Bypass Grafts
- •Tissue Coverage
- •Common Vascular Exposures and Reconstructions
- •Upper Extremity
- •Key Points
- •Further Reading
- •Introduction
- •Who Needs Damage Control Surgery?
- •Damage Control Laparotomy
- •The Venue
- •Patient Position
- •The Technique
- •The Incision
- •Once Inside
- •Then What?
- •Total Haemorrhage Control
- •The Retroperitoneum
- •Hollow Viscus Injury
- •Other Important Injuries Not to Miss
- •At the End of Damage Control Surgery Stage I
- •Additional Reading
- •Introduction
- •Pelvic Anatomy and Haemorrhage
- •Damage Control for Pelvic Haemorrhage
- •Technique of Pelvis-Only Extraperitoneal Pelvic Packing
- •Technique of Extraperitoneal Pelvic Packing via the Abdomen
- •Other Strategies
- •Additional Reading
- •10. Abdominal Injuries
- •Resource Limitation Concerns
- •Brief Review of Material
- •How to Do It?
- •Aortic Control
- •Abdominal Compartments
- •Liver
- •Liver Suturing (Deep Suture Repair)
- •Omental Plugging (Packing)
- •Local Haemostatic Agents
- •Hepatic Balloon Tamponade
- •Spleen
- •Mesentery
- •Retroperitoneal Haemorrhage
- •Major Abdominal Vascular Injuries
- •Kidney
- •Diaphragm
- •Pancreas
- •Hollow Viscus Injuries
- •Oesophagus
- •Gastric Injuries
- •Duodenum
- •Small Bowel
- •Colon and Rectum
- •Urinary Tract Injuries
- •Ten Key Points
- •Further Reading
- •11. Acute Care Emergency Surgery
- •Resource Limitation Concerns
- •Acute Appendicitis
- •Procedure
- •Hernia
- •Umbilical and Paraumbilical Hernia Repair
- •Inguinal Hernia Repair
- •Right Hemicolectomy
- •Surgical Considerations
- •Left Hemicolectomy
- •Stoma Formation
- •Perforation of Gastric and Duodenal Ulcers
- •Operative Versus Non-operative Management
- •Further Reading
- •Introduction
- •Anatomical Considerations
- •Physiological Considerations
- •The Initial Assessment
- •Airway
- •Breathing
- •Circulation
- •Vascular Access
- •Fluid Resuscitation
- •Disability
- •Exposure
- •Imaging
- •Assume Every Child Is Sick
- •Tranexamic Acid (TXA)
- •Massive Transfusion
- •In the Operating Room
- •Further Reading
- •Damage Control Principles
- •Resource Limitation Concerns
- •Procedures
- •Wound Incision
- •Wound Excision
- •Amputation
- •Application of Splints and Casts
- •Upper Extremity
- •Lower Extremity
- •Application of Traction
- •Application of Extremity External Fixation
- •Upper Extremity
- •Lower Extremity
- •Application of Pelvic External Fixation
- •Key Points
- •Further Reading
- •Cranial Trauma
- •Introduction
- •Considerations
- •Common Cases and Treatment
- •Blast Injury
- •Ballistics
- •Closed Head Injuries
- •Spinal Trauma
- •Introduction
- •Military Versus Civilian
- •Spinal Column Injury
- •Spinal Cord Injury
- •Key Points
- •Further Reading
- •Resource Limitation Concerns
- •Step-by-Step Procedures
- •Exsanguinating Haemorrhage
- •Airway Provision
- •Step-by-Step Procedure 1: Surgical Cricothyroidotomy
- •Cervical Spine Immobilisation
- •Management of Facial Haemorrhage
- •Step-by-Step Procedure 2: Arresting Facial Bleeding by Nasal and Oral Packing
- •Damage Control Surgery for Penetrating Neck Injury
- •Investigations of Penetrating Neck Injury
- •The Use of Neck Zones
- •Zone 1 Injuries
- •Zone 2 Injuries
- •Zone 3 Injuries
- •Surgical Treatment of Penetrating Cervical Vascular Injury
- •Step-by-Step Procedure 3: Access to the Common Carotid Artery in Neck Zone II
- •Surgical Treatment of Laryngotracheal Injuries
- •Surgical Treatment of Oesophageal Injuries
- •Soft Tissue Facial Trauma
- •Imaging of Facial Fractures
- •Internal Fixation of Facial Fractures
- •External Fixation of Facial Fractures
- •Ten Key Points
- •Further Reading
- •Introduction
- •Recognise That Ocular Pathology is Present
- •History
- •Examination
- •Inspect the Eyes
- •Closed Globe Injury
- •Orbital Compartment Syndrome
- •Visual Acuity Is Tested as Follows
- •Pupils Are Tested as Follows
- •Chemical Injury
- •Orbital Compartment Syndrome
- •Open Globe Injury
- •Hyphaemia
- •Retinal Detachment and Dialysis
- •Closed Globe Injuries After Refractive Surgery
- •Understand How to Safely Temporise and Package Serious Ocular Pathology
- •Chemical Injury
- •Orbital compartment syndrome
- •Open Globe Injuries
- •Closed Globe Injuries
- •Retinal Detachments
- •Closed Globe Injuries After Refractive Surgery
- •Understand Some of the Issues Around Prolonged Care of Eye Injuries, Including the Effect of Delay and the Risk of Sympathetic Ophthalmia
- •Further Reading
- •Introduction
- •Tissue Response to Injury
- •Debridement
- •Extension Lines
- •Fasciotomy of the Extremities
- •Overview
- •Resource Limitation Concerns
- •Diagnosis
- •Surgical Technique
- •Foot
- •Thigh
- •Hand
- •Dorsal
- •Palmar
- •Digital
- •Forearm
- •Burns
- •Overview
- •Resource Limitation Concerns
- •Acute Management
- •Airway
- •Breathing
- •Circulation
- •Disability
- •Exposure
- •Fluids
- •Adjunctive Measures
- •Dressings
- •Burn Excision
- •Electrical Burns
- •Chemical Burns
- •Peripheral Cold Injury
- •Overview
- •Resource Limitation Concerns
- •Clinical Presentation
- •Assessment
- •Management
- •Plastic Surgery Reconstructive Elevator
- •Principles
- •Skin Grafts
- •Types
- •Local Flaps
- •Vascularity
- •Composition
- •Method of Movement
- •Procedure and Equipment Details for Local Skin Flaps
- •Suggested Reading
- •Resource Limitation Concerns
- •Limitations of Diagnosis
- •Limitations of Treatment
- •Bone Conducting Hearing Systems
- •Knowledge Update (Brief Review of Material)
- •Key Concepts
- •Further Reading
- •Introduction
- •Haemorrhage
- •Management
- •Hypertensive disorders
- •Sepsis
- •Abortion
- •Obstructed Labour
- •Caesarean Section
- •Indications
- •Techniques
- •Postoperative Care
- •Caesarian Section for Breech Delivery
- •Types and Definitions
- •Key points:
- •Further Reading
- •Index

242 | Index
injuries, 46; for hilar injuries, 52–3, 54, 55; left
anterolateral thoracotomy, 47, 47–9; lung
parenchymal haemorrhage control in, 46;
mortality rate, 45–6; overview, 45–7; for posterior
mediastinal injuries, 54–8; aortic control, 54–5;
combined tracheobronchial injuries, 58;
oesophageal injury, 57–8, 59; tracheobronchial
injury, 55–7, 57, 58; pulmonary injuries, 53–4, 55,
56; for tracheobronchial and oesophageal
injuries, 45
thrombectomy, 70–1, 71
thromboxane A2, 204
tibia, 146, 190
tibial vessels, 81
tissue coverage, 73
tissue plasminogen activator, 204
tracheobronchial injury, 55–7, 57, 58
traction, 142–4, 143; see also orthopaedic injury
management
tranexamic acid (TXA), 34, 134–5; see also fluid
administration
transposition flaps, 208
transverse arteriotomy closure, 71
trauma control laparotomy, 83–8; end of, 88; equipment,
84; exteriorising the small bowel, 85, 85;
haemorrhage control, 85–7; hollow viscus injury,
87; incision, 85; injuries not to miss, 88; key
points, 88; overview, 83–4
trauma-induced coagulopathy (TIC), 28
traumatic brain injury (TBI), fatality rate, 151
Treitz ligament, 109, 114
umbilical hernia repair, 122, 122–5, 123
unilateral collar incision, 168
upper extremity, 73–81, 141, 144–5; elbow, 144–5; forearm,
145; wrist, 145
urinary tract injuries, 115–6; see also abdominal injuries
vascular control, 69–70
vascular exposures and reconstructions, 73–81; axillary
vessels, 73, 74; brachial vessels, 73–7; popliteal
vessels, 77–81; superficial femoral artery, 77;
techniques, 69–73; anticoagulation, 70–1; bypass
graft, 72–3; focal repairs, 71; injury exposure, 70;
interposition graft, 72–3; thrombectomy, 70–1, 71;
tissue coverage, 73; vascular control, 69–70; tibial
vessels, 81; upper extremity, 73–81
vascular injuries, 108–11; ligation, 109–10; shunting, 110–1
vehicles, blast effects in, 12, 12
vein injury management, 69
venous plexus, 91
Vicryl sutures, 113
Vietnam War, 2
Virsung duct, 113
vital signs, normal, 133
volcanic eruptions, 17–8
V-Y advancement Flaps, 210
Walking Blood Bank (WBB) Program, 34
whole blood, 31–2; see also fluid administration
wound excision, 139–40, 140
wound incision, 138–9, 139
wrist, 141, 146
xenograft, 205
xylocaine, 217, 219
Yemen, 4
zone I haematoma, 113
zone I injuries, 167
zone II haematoma, 113
zone II injuries, 167, 169
zone III haematoma, 113
zone III injuries, 167–8
vagus nerve, 169
vascular access, 133
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