Soft tissue compression

As mentioned above, for the occurrence of a bruise, a quick and short-term action of a traumatic force is necessary. When squeezing, the traumatic force acts much more slowly over a more or less long time. Violation of the integrity of the skin during compression also does not occur, but soft tissues can be damaged to a large extent. As a result of compression in the muscles dystrophic changes occur, areas of necrosis appear, subsequently undergoing connective tissue organization, and sometimes ossification. Compression of the nerve trunks (for example, with prolonged compression of the limb with a tourniquet) can lead to paralysis.
With prolonged compression of vast areas of soft tissue of the limbs, a peculiar clinical picture of traumatic toxicosis develops (“compression syndrome”, “crushing syndrome”). Such damage is not uncommon during landslides in mines, earthquakes, collapses of buildings during the bombing. In this regard, the injured limb is bloodless, pale, sometimes there are cyanotic spots, fingers and the entire peripheral part of the limb (distal from compression) of cyanosis. Blood circulation and sensitivity in such a limb are impaired, movements are impossible. Due to the absorption of the decay products of damaged tissues, severe toxicosis develops, followed by a violation of the excretory system of the kidneys, detoxification function of the liver and toxic damage to the nervous system. At first, within a few hours (4-6), the general condition of the victim is more or less satisfactory, then a picture of severe shock develops, accompanied first by psychomotor agitation, and then depression of all functions and drowsiness. At the same time, toxic damage to parenchymal organs (liver, kidneys), plasmorrhea with blood clotting is noted. In more rare cases, all these changes are reversible, and recovery gradually comes. In severe cases, degenerative changes in the liver and kidneys develop, the damaged limb swells sharply, becomes dense, non-viable. The most severe cases end in death. Local treatment consists in early dissection of the soft tissues of the iB crushing centers with the introduction of tampons soaked in hypertonic solutions of sodium chloride. Amputation is sometimes indicated. The goal of general therapeutic measures is to normalize the metabolism, in the fight against renal and liver failure and shock. 

local_offerevent_note November 4, 2019

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