Polytrauma

Polytrauma (from the Greek poly — many and trauma — wound, physical injury) is an extremely severe pathological condition characterized by the simultaneous presence of two or more injuries in various anatomical regions.

At least one of these injuries or their combination poses a direct threat to the patient’s life.

Etiology and pathophysiology

The cause is always the impact of massive kinetic energy, typical of serious road accidents, falls from great heights, or industrial disasters. Pathogenesis is determined by the development of a mutual aggravation syndrome, where damage to one system critically worsens the function of another.

In response to massive tissue destruction, an uncontrolled systemic inflammatory reaction is triggered in the body. A highly dangerous condition in the pathophysiology of polytrauma is the development of the “lethal triad.” It includes critical heat loss from the body, dangerous acidification of the blood due to shock, and fatal blood coagulation disorders.

Clinical significance

Polytrauma is accompanied by profound traumatic shock, massive blood loss, and impairment of vital functions. The assessment of the severity of the patient’s condition is conducted by anesthesiologists using special international scoring scales.

Treatment is based on the modern concept of damage control surgery. In the initial hours, only life-saving and minimally traumatic operations are performed: stopping bleeding, stabilizing broken pelvises, and decompressing the brain. Definitive osteosynthesis of all fractures is strictly postponed until the patient’s condition is fully stabilized.