[Basic principles and methods of aid to patients with severe hand trauma]

Aid rendering to the patients with severe hand trauma is presented as a system of primary-reconstructive treatment, including individual approach to the surgical aid tactics, terms and volume selection, where the defining factors are the state of tissue blood circulation, application of the complex of conservative and operative measures aimed at the prophylaxis and therapy of circulatory and infectious complications, selection of rational methods of the lost anatomic formations reconstruction. There are described clinical criteria of tissue vitality evaluation and those obtained with application of instrument methods (infrared thermography, electric resistance thermometry, ultrasound indication of blood flow). If the state of the damaged hand tissues requires medicinal treatment it would be expedient to carry out the primary-postponed treatment, consisting of 2 stages. The first stage includes surgical manipulation, aimed at microcirculation improvement and wound surface isolation by means of watertight cover. The second stage is the final one. Its volume depends upon the compensation of tissue blood flow and is carried out for 2-5 days in planned order.