A combined injury is multiple damage (two or more) to different anatomical parts of the body that a patient received at the same time or within a short period.
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A combined injury is multiple damage (two or more) to different anatomical parts of the body that a patient received at the same time or within a short period.
A combined injury is simultaneous damage to two or more parts of the body, for example the head and chest, or the spine and abdominal organs, sustained in a single event. The condition is life-threatening: the injuries aggravate one another, and internal ones are often not visible from the outside, so the injured person must be examined and treated by doctors.
In brief:
At CSM Clinic in Kyiv, a surgeon and physical rehabilitation specialists provide consultations: they can help assess the consequences of the injury and plan recovery once the condition has stabilized.
A combined injury is multiple damage (two or more) to different anatomical parts of the body that a patient received at the same time or within a short period. For example, a traumatic brain injury and a spinal fracture, chest injury and a ruptured spleen, etc. A combined injury is one type of polytrauma: its main difference is that the injuries have different locations and require differentiated treatment approaches. The danger to life with combined injuries is very high.
Polytrauma in road accidents, man-made disasters, multiple injuries to the body in falls from a height, and workplace injuries are the main causes of combined injuries. They are among the main factors contributing to mortality in the population aged 18-43.
Closed injuries of internal organs are not always noticeable, so only a specialist can make an accurate diagnosis. For example, a polytrauma of the chest may show as pallor, difficulty breathing, loss of consciousness and similar symptoms, which a layperson would not recognize as signs of a combined injury. But it may also be characterized by multiple visible bruises, one or several instances of bleeding, and a state of shock.
To identify polytrauma, it is necessary to consult a doctor. But its presence should be assumed before the ambulance arrives if:
In each of these cases, the patient should not be moved unless it is vitally necessary.
At the clinic, professional diagnostics will be carried out, including assessment of the severity of the polytrauma and identification of injuries that threaten the patient's life. Pulse and blood pressure are always measured, and a rapid blood group test is performed. Depending on the injured area, an X-ray of the damaged area is taken. For a head polytrauma this may be echoencephalography, which can detect intracranial hematomas and swelling. It is performed together with a skull X-ray for combined facial injuries as well.
Ultrasound is prescribed for injuries of the abdominal cavity, and X-ray is a universal way to detect fractures and displacements. Any clinic in Ukraine can perform this type of examination.
More specialized tests that make it possible to evaluate organ function, such as a biochemical blood test, are also prescribed. For example, urea and creatinine in plasma indicate kidney damage.
Diagnostics of combined injuries must be carried out by specialist doctors: a traumatologist, surgeon and intensive care physician.
Book an appointment: Orthopedic traumatologist consultation in Kyiv
After polytrauma is diagnosed, the first stage of comprehensive treatment is anti-shock therapy. Bleeding is stopped with a tourniquet or clamp; for internal bleeding, surgery is performed to prevent blood loss. If fractures are diagnosed, the patient is fully immobilized and the damaged limbs are fixed.
In most cases, surgery is needed for combined head injuries (brain compression, intracranial hematomas, etc.). Chest cavity injuries often require drainage for pneumothorax and hemothorax. Treatment of combined injuries should be carried out by several specialists who provide a comprehensive approach to the different injuries. Their actions are based on medical protocols, so treatment of polytrauma in Kyiv or any regional center in Ukraine should not differ significantly.
After surgery, fixation of fractures or other treatment measures, the patient is transferred to an intensive care unit and a combined injury treatment program is prescribed. Depending on the diagnosis, this may include infusion of blood substitutes, drugs to restore the functioning of organs and systems, drain replacement, dressings, etc.
Treatment of a combined injury is a long and complex process. After the condition of a patient with polytrauma has stabilized, the patient is transferred to the trauma department. If complications arise, doctors may consult narrow specialists in Kyiv or a specialized clinic.
Rehabilitation after polytrauma depends on the type and number of injuries, but in any case it will take a long time until full recovery. Individual injuries may be minor, but in combination their consequences significantly worsen the patient's condition. It is necessary to consult a specialist at the clinic regularly in order to avoid complications or regression.
All three are types of polytrauma but differ in essence. In a combined injury, different parts of the body are affected, for example the head and chest. In a multiple injury there are several injuries but in one area, for example fractures of several leg bones. A combined-factor injury arises from different agents at the same time, for example a blow together with a burn or exposure to chemicals.
A combined wound is damage to several anatomical areas by a single injuring agent, for example the chest and abdomen in a shrapnel or knife wound. In essence it is the same combined injury, only caused by a wounding object. Such cases are assessed and treated in a hospital with the involvement of surgeons.
Because the injuries aggravate one another. Blood loss from one wound, pain, breathing problems with a chest injury and brain swelling with a head injury together lead to shock more quickly. Moreover, some internal injuries are not visible and are easy to miss. That is why the injured person is examined fully, not only where it hurts most.
Call 103 or 112 and say clearly what happened. Do not move the injured person unless there is a direct threat to life, such as fire. Stop severe bleeding by pressing on the wound or with a tourniquet above it on a limb. Do not give food or drink, cover the person to keep them warm, and monitor breathing and consciousness until the crew arrives.
There is no exact timeframe: it takes months and sometimes longer. Everything depends on the number and severity of the injuries, surgeries, age and concomitant diseases. Rehabilitation usually goes in stages: first the hospital, then recovery supervised by a rehabilitation specialist with physical therapy, massage and physiotherapy, followed by regular visits to the doctor.
Not in the acute period: intensive care, an operating room and round-the-clock supervision are needed, that is, a hospital with a trauma center. The clinic becomes involved later: it helps assess the consequences, monitor healing and select recovery measures. That is why, when a combined injury is suspected, an ambulance is called first rather than going to a doctor on your own.
