Almost all the wounded who end up in Russian hospitals from the Northern Military District return to duty, and the mortality rate does not exceed 0.45% - this is several times less than during military conflicts of the recent past, the head of the main military clinical hospital said in an interview with Izvestia. hospital named after N.N. Burdenko Denis Davydov. Over the past year and a half, Russian military doctors have gained unique experience that no other country in the world has, he is sure. What this experience consists of, why the nature of injuries has changed, what operations are now performed right on the line of combat contact, and how modern exoprosthetics allow soldiers to remain in service - read in Izvestia’s conversation with Denis Davydov. “The means of destruction have changed a lot”
— What are the features of a special military operation compared to previous conflicts from the point of view of military medicine?
— The SVO is enormously different from the combat operations that we faced 15–20 years ago. A huge number of unmanned weapons are used that do not require the direct participation of people. The means of destruction have changed greatly, they have become more sophisticated.
We see that there are relatively few bullet wounds - about a quarter. The rest are mine-explosive and fragmentation. And the wounding elements have become different : materials that cause the greatest damage are now selected for them, and there are a lot of them.
The medical service had to learn all this very quickly and quickly adapt . It turned out, in general, quite successfully.
— We communicate at the International Forum on Surgery of Contemporary Armed Conflicts. Do Russian military doctors have anything to tell about it, based on the experience of the SVO?
— There are a number of technologies, the use of which on the battlefield 10–15 years ago we could not imagine, but today this is the practice of military doctors. First of all, this is prosthetics for the main functions of the body - the heart, lungs - directly on the line of combat contact. This technique is called extracorporeal membrane oxygenation (ECMO). Previously, damage to large vessels, the heart, and lungs inevitably led to death. Now, immediately after being wounded, almost in a trench, we can establish this system and ensure the functioning of the vital functions of the body.
We learned how to quickly immobilize a wounded person. We have rod devices that help to completely immobilize a segment of any limb in 15–20 minutes.
Operational intervention: the first ambulance train was sent to the Northern Military District zone
It will provide urgent assistance to the wounded, their recovery and evacuation.
These technologies were previously unavailable so close to the war zone. Now this makes it possible to save the lives of military personnel, quickly prepare them for transportation, provide pain relief, carry out anti-shock measures, and then transport them for further treatment.
Today we have stronger drugs: painkillers, antibiotics, drugs that help correct the psychological state of military personnel.
“Exoprosthetics have reached a new level”
— At the forum it was said that the concept of “non-transportable wounded” is disappearing. Has this problem really been solved?
— The Afghan and Chechen campaigns confirmed the experience of the Great Patriotic War: medical evacuation measures have their own laws, and they must be strictly observed.Many pathologies were considered a contraindication for transportation. Now we can say that only head wounds remain such an obstacle : you have to be careful there, and you cannot evacuate immediately after a wound or operation. As for injuries to all other segments of the body, we can safely deliver any wounded person in any condition to the stage of highly qualified medical care.
— Have you been able to reduce the mortality rate among the wounded?
— Hospital mortality now does not exceed 0.45%. And this is a colossal breakthrough for the military medical service. During the Great Patriotic War this figure was 7.5%, during the Afghan campaign - 4.4%, during the fighting in the North Caucasus - 1.1%. As for hospital mortality in the Ukrainian Armed Forces, it is many times higher.
Protective cover: a gun that heals wounds has been created in Russia
How a new development will help doctors in a combat zone
— One of the topics discussed at the forum is the increase in the proportion of wounded who return to duty after treatment. What is the dynamic here?
— During the Great Patriotic War, doctors returned about 75% of the wounded to duty. Now we manage to return 98%. The rest are forced to take a commission due to health reasons.
Previously, people with an amputated arm or leg had to leave the Armed Forces. With rare exceptions, of course: we remember them from literature - for example, the pilot Alexei Maresyev. Now this has become a common occurrence.
- What does this have to do with?
— Firstly, a new level of exoprostheses. As you pass by, you won’t even notice that the person is missing a limb or a segment of it, and it has been replaced with an exoprosthesis.And besides, we have quite a lot of positions, and there is a need for these people to continue serving in the Armed Forces and continue to help the army.
After severe injuries, people return to serve in units where staff work and training are carried out. These people have vast experience, the Ministry of Defense needs them.
Even during the rounds that we constantly conduct in the hospital, many of those who have serious injuries ask: “Can I remain in the Armed Forces? I want to continue to serve, please leave me.” Naturally, we are doing everything possible to socialize them and prevent the army from losing experienced servicemen. “Many civilian doctors came as volunteers and went to the Northern Military District zone”
— What problems do military doctors most often encounter?
“It is very difficult for us to combat the resistance of microorganisms and their growing resistance to antibiotics.
We also need technologies that make it possible to safely prosthetize the vital functions of the body.
Materials are needed that will be even more inert and will not interact with bone and soft tissue, allowing for individualization of the design. Although already now the lion's share of designs are, in fact, printed on a 3D printer and have an individual character for a particular wounded or injured person. This needs to be developed, this is the future.
— Do you feel supported by your civilian colleagues?
— After the start of the special military operation, civilian hospitals, institutes, federal and other centers called and offered help. Many doctors came as volunteers and went to the North Military District zone. And now many travel and sign contracts for military service. We were not left alone. The medical service of the Armed Forces felt the shoulder and saw that it had a huge resource to replenish its ranks with qualified specialists. And these people come not under duress or in search of some benefit, but at the behest of their hearts.
Late payment: when will doctors’ salaries be increased?
The implementation of the new remuneration system has been postponed once again
The North Atlantic Alliance, which has a huge amount of technology, people, resources, money, and capabilities, is actually fighting against us. We are confronting, essentially, alone. But time has shown that we have turned from twigs into a bundle that cannot be broken. Our level of consolidation is one of the keys to success.
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