Current aspects of medical care for children with extensive soft tissue injuries (Description of three clinical observations with an analysis of mistakes)

BACKGROUND: Injury is an epidemic of the 21st century. It is associated with the increasing high-speed transportation, natural and man-made emergencies, and local wars. All this leads to the appearance of patients with complex, multiple, and not rarely combined injuries. Traumatic skin detachment is the result of high-energy trauma. The treatment of this patient group presents certain difficulties due to the provisional peculiarities of medical care because of the severity of these patients condition of such patients and the underlying muscle tissue destruction. CLINICAL CASES: This paper presents several clinical examples of successfully treated patients with traumatic skin detachments as a part of polytrauma. The timely correction of the improper treatment procedures enabled avoiding unfavorable results. DISCUSSION: Treatment of victims with traumatic skin detachment who are in a relatively stable state and the absence of destruction of the underlying muscle tissues should be performed using traditional full layer free skin grafting, according to Krasovitov. In contrast, the treatment of victims with traumatic full-thickness skin detachment in an unstable (decompensated) state and the destruction of the underlying muscle tissues, it is necessary to perform it using the technology of staged full layer free skin grafting with the possible use of a biological coating based on chitosan. CONCLUSION: The presented clinical examples reflect the importance of developing a unified method of treating injuries at all stages of organizing medical assistance to the victim.