Traumatology

TRAUMATOLOGY, the science of trauma, of injuries. T., which is essentially a branch of surgery, must develop into an independent discipline. The organization and study of T. are dictated not only by the rapid growth and development of surgery, but also by the urgent demands of our growing industry, the collectivized village, the growth of cities, and finally by the interests of national defense. Until now, surgeons have not paid sufficient attention to questions of T., often being satisfied with the immediate effect—saving the life of the trauma victim—and little interested in the long-term results of treatment. Meanwhile, our state gives us a specific social order: not only the preservation of life, but also the complete restoration of working capacity of the injured person. For this reason, T. is currently being studied as a coherent system, covering in its analysis the causes (social roots) of trauma, its mechanism, clinic and course. Methods for treating trauma victims are being sought, tested from the point of view of their theoretical validity and practical effectiveness, with the basis for evaluation being the completeness of restoration of working capacity. For this purpose, the provision of first aid and medical care to trauma victims is organized in an appropriate manner, which is specific and requires the development of a special network of medical institutions, the main feature of which is staging, proper deployment of forces, organization of first aid at the site, transportation, trauma points-cabinets (outpatient clinics), trauma departments (inpatient facilities), special trauma institutes, which combine the activities of these stages. The main feature determining the nature of care for trauma victims at these stages is the need for rapid pace, which is dictated by the very essence of trauma. Aseptic dressings, splints, primary treatment, primary suture, primary operation, fracture reduction, etc.—all this is performed within the first hours after injury, but to carry this out, clear organization is needed. At all stages of this network, assistance is provided by fully qualified physicians for this purpose, and at the final stages (outpatient clinic, inpatient facility)—by trauma specialists. The establishment of specialized trauma departments and trauma institutes, which make it possible to concentrate all trauma in one hand, study it, and develop unified diagnostic and treatment methods based on extensive material, has great clinical and social significance. In trauma institutes, in addition to complete facilities and equipment for providing immediate surgical assistance, there should also be appropriate departments and departments that make it possible to bring the treatment of trauma victims to completion, to full restoration of working capacity—departments of therapeutic physical education, physio- and mechanotherapy, prosthetic workshops, departments of occupational therapy, and finally a polyclinic for further observation and accounting of long-term treatment results. Proper trauma care is an extremely urgent task in our country, the fulfillment of which depends: 1) on the organization of a proper network of trauma care institutions (health post, trauma cabinet, trauma department, trauma institutes), 2) on the organization of transportation (emergency care), 3) on equipment (apparatus, X-ray, etc.), 4) on the training of trauma specialists. Cadres of specialist trauma specialists are formed from surgeons who undergo a special course in T. in improvement institutes or are sent for several months to "workplaces" in trauma institutes. T. is the foundation of field surgery, its scientific justification. The experience of war served as material that gave new directions in modern T. On the other hand, T. as an independent discipline allows to a certain extent to test in peacetime experience the basic principles and methods of treatment that have defensive significance. Lit.—see lit. to art. War, Psychic trauma, Safety engineering, Traumatism, Traumatic neuroses.