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The objective is to determine the optimal tactics in treatment of combined trauma using the objective assessment of the severity of injuries and the overall condition of the casualties.Material and methods. The article presents the materials on biometric analysis of treatment of casualties with combined trauma in the program of multi-staged surgical treatment.Results. In the process of multi-staged surgical treatment, we can determine the prognosis, the nature of the traumatic disease with the help of a biometric comprehensive study that will optimize comprehensive treatment program and rehabilitation of casualties in the trauma center of the 1st level.Conclusion. The conditions for the application of the full spectrum of surgical interventions in the maxillofacial region in the acute period of traumatic disease are created in favorable prognosis. The choice of treatment in favorable or unfavorable prognosis is a multistaged surgical tactics of treatment – Damage control surgery.

OBJECTIVE. The article presents the complex management of treatment in multiple trauma using endovideoassisted surgeries. MATERIAL AND METHODS. The authors demonstrated minimally invasive methods of treatment for victims with multiple trauma on the second stage of programmed multiple-stage surgery in order to eliminate life-threatening consequences and fix fractures of facial skeleton. These operations were performed during 12 hours after trauma. RESULTS. Programmed multiple stage treatment included the prevention or stop of asphyxia, bleeding and temporary fixation of fractures using extrafocal osteosynthesis and elements of primary plasty of soft tissues. Surgeons created conditions for intensive therapy (tracheostomy) using minimally invasive methods. CONCLUSIONS. Endovideo-assisted technique decreased trauma of surgical approach and allowed doctors to perform revision of complex anatomical structures, which were difficult to access. It expanded the volume and possibilities of surgical manipulations. Surgeons differentially removed foreign bodies and areas of necrosis. The method increased an accuracy of reconstructive surgeries and facilitated to monitoring of damaged structures.

The authors described the variants of initial surgical d-bridement on the basis of experience of treatment of 183 patients of multistaged treatment program.