smpСкорая медицинская помощьEMERGENCY MEDICAL CARE2072-6716Northwest State Medical University named after II Mechnikov10.24884/2072-6716-2022-23-1-50-61smp-538Research ArticleСТАТЬИARTICLESКомпрессионные устройства для временного гемостаза при ранениях живота и смежных подвздошно‑паховых областей (обзор литературы)Compression devices for temporary hemostasis in injuries of the abdomen and adjacent ileo‑inguinal areas (literature review)СамохваловИ. М.SamokhvalovI. M.

Самохвалов Игорь Маркеллович — доктор медицинских наук, профессор, заведующий кафедрой военно‑полевой хирургии

194044, Санкт‑Петербург, ул. Академика Лебедева, д. 6ж

Igor M. Samokhvalov

St. Petersburg

igor-samokhvalov@mail.ruПетровА. Н.PetrovA. N.

Петров Александр Николаевич — доктор медицинских наук, профессор кафедры военно‑полевой хирургии

194044, Санкт‑Петербург, ул. Академика Лебедева, д. 6ж

Aleksandr N. Petrov

St. Petersburg

mmadokpan@rambler.ruГришинМ. С.GrishinM. S.

Гришин Максим Сергеевич — адъюнкт кафедры военно‑полевой хирургии

194044, Санкт‑Петербург, ул. Академика Лебедева, д. 6ж

Maksim S. Grishin

St. Petersburg

al13max@mail.ruГоловкоК. П.GolovkoK. P.

Головко Константин Петрович — доктор медицинских наук, доцент, доцент кафедры военно‑ полевой хирургии

194044, Санкт‑Петербург, ул. Академика Лебедева, д. 6ж

 

Konstantin P. Golovko

St. Petersburg

vmeda-nio@mail.ruВоенно-медицинская академия им. С. М. КироваРоссияKirov Military Medical AcademyRussian Federation2022120420222315061Copyright © Самохвалов И.М., Петров А.Н., Гришин М.С., Головко К.П., 20222022Самохвалов И.М., Петров А.Н., Гришин М.С., Головко К.П.Samokhvalov I.M., Petrov A.N., Grishin M.S., Golovko K.P.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://smp.spb.ru/jour/article/view/538

В обзоре проведен анализ литературы об экспериментальном обосновании и опыте практического применения устройств для остановки внутрибрюшного и наружного кровотечения в подвздошно‑паховых областях путем создания внешней локальной компрессии. Цель исследования: проанализировать порядок применения, эффективность и параметры безопасного использования «абдоминальных турникетов» для локальной компрессии живота и подвздошно‑паховых областей при продолжающемся кровотечении, повреждении сосудов подвздошно‑бедренного сегмента, а также при высоких отрывах бедра, когда невозможно фиксировать классический жгут. Материалы и методы исследования. Выполнен анализ современной отечественной и зарубежной литературы, посвященной конструктивным особенностям основных моделей устройств по созданию внешней компрессии в области живота и смежных областей тела, опыту и результатам их применения в лабораторных и реальных условиях. Результаты исследования. К основным изделиям вышеописанного назначения относятся следующие модели: AAJT (Abdominal Aortic and Junctional Tourniquet), CRoC (Combat Ready Clamp), JETT (Junctional Emergency Treatment Tool), SJT (SAM Junctional Tourniquet). Рассмотренные устройства по созданию локальной компрессии обеспечивают временный гемостаз при внутрибрюшном кровотечении, ранении крупных сосудов подвздошно‑паховых областей и высоких отрывах бедер, но их применение имеет ряд особенностей, влияющих на эффективность остановки кровотечения. Заключение. Рассмотренные компрессионные устройства имеют конструктивные особенности и ограничения, поэтому при создании отечественного аналога необходимы дополнительные данные по алгоритму использования в зависимости от области ранения и предполагаемого источника кровотечения, сроков фиксации, а также возможного сочетания данного метода временного гемостаза с другими перспективными способами остановки кровотечения на догоспитальном этапе.

The review analyzes the available literature on the experimental justification and experience of practical application of existing promising devices for stopping intra‑abdominal and external bleeding in the ilio‑inguinal regions by creating an external local compression. Objective: to analyze the order of application, effectiveness and parameters of safe use of “abdominal tourniquet” for local compression of the abdomen and ilio‑inguinal areas with continued bleeding into the peritoneal cavity and pelvic tissue, damage to the vessels of the ilio‑femoral segment, as well as with high hip detachments, when it is impossible to fix the classic tourniquet. Materials and methods. The analysis of modern domestic and foreign literature, the sacred relevance of the pathology under consideration, the constructive features of the main models of devices for creating external compression in the abdomen and adjacent areas of the body, the experience and results of their application in laboratory and real conditions is carried out. Results. The obtained data allow us to assert that today the following four models belong to the main products of the above‑described purpose: AAJT (Abdominal Aortic and Junctional Tourniquet), CRoC (Combat Ready Clamp), JETT (Junctional Emergency Treatment Tool), SJT (SAM Junctional Tourniquet). The considered devices for creating local compression provide temporary hemostasis in intra‑abdominal bleeding, injury of large vessels of the ilio‑inguinal regions and high separation of the thighs, but their use has a number of features that affect the effectiveness of stopping blood flow. Conclusion. The considered compression devices have design features and limitations, so when creating a domestic analog, additional data on the algorithm of use is needed, depending on the area of the wound and the intended source of bleeding, the timing of fixation, as well as the possible combination of this method of temporary hemostasis with other promising methods of stopping bleeding at the pre‑hospital stage.

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The authors declare that there are no conflicts of interest present.