Application of Damage Control Orthopaedics Combined with Multidisciplinary Team Collaboration Trauma First Aid Mode in the Treatment of Severe Traumatic Fracture with Massive Bleeding
Objective:To observe the application effect of damage control orthopaedics(DCO)combined with multidisciplinary team collaboration(MDT)trauma first aid mode in the treatment of severe traumatic fracture with massive bleeding.Methods:A total of 108 patients with severe traumatic fracture and massive bleeding who were admitted to the hospital from January to September 2023 were selected.They were divided into an observation group and a control group using the random number table method.The control group was given conventional treatment,and the observation group was given DCO combined with MDT trauma first aid mode.The pre-operative injury severity score(ISS),treatment outcomes,perioperative heart rate(HR),systolic blood pressure,24-hour urine volume,coagulation function[prothrombin time(PT)and activated partial thromboplastin time(APTT)],and inflammatory factors[tumor necro-sis factor-α(TNF-α),interleukin-1(IL-1)and interleukin-6(IL-6)]were compared between the two groups.Postoperative fracture heal-ing,the incidence rates of complications,and in-hospital mortality rates in both groups were recorded.Results:The shock control time,intraoperative blood loss and hospital stay of the observation group were less than those of the control group(P＜0.05).Six hours after surgery,HR of both groups decreased,and HR of the observation group was lower than that of the control group(P＜0.05).Six hours after surgery,systolic blood pressure and 24-hour urine volume of both groups increased.Systolic blood pressure and 24-hour urine volume of the observation group were higher than those of the control group(P＜0.05).There was no significant difference in PT or APTT in the two groups before surgery and at 6 hours after surgery(P＞0.05).Perioperative TNF-α,IL-1 and IL-6 levels showed significant differences in terms of inter-group effect,time effect and interaction effect(P＜0.05).The levels of TNF-α,IL-1 and IL-6 in both groups on day 3 and day 7 after surgery were lower than preoperative levels,and the observation group were lower(P＜0.05).Compared with the control group,the observation group had a lower in-hospital mortality rate and better fracture healing(P＜0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P＞0.05).Conclusion:DCO combined with MDT trauma first aid mode can reduce intraoperative blood loss,shock duration and hospital stay of patients with severe traumatic fracture and massive bleeding.At the same time,it helps to improve perioperative hemodynamics and inflammatory response,promote fracture healing,and reduce mortality.
Damage control orthopaedicsMultidisciplinary team collaborationTrauma first aidSevere traumaFractureMassive bleeding
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