[000:00:46;00] challenges were put before this society, and the medicine that is located always belongs to the objects of critical infrastructure, it was the first to be forced to face the war, the war united all departmental hospitals, all departmental medical facilities, what used to be said about a single medical space, it is now, we really cooperate with military doctors, with all the leading hospitals, with all medical structures that provide assistance to the people of ukraine , this is also the wounded of this military , this is the displacement of persons, this is also the civilian of each

of us, the war has left a memory to their own your stories, some impressions, some moments that you would like to forget. but you will never forget them in 2013, when the first injuries began to arrive. you know what i remember about the war, this war has its own specific smell. this smell cannot

be compared to anything . the mechnikov hospital provides assistance to the wounded for 14-15 years we didn't know all the hot spots that were happening in the east of ukraine, but from february 24, when the full-scale invasion began, we felt that we would have to work much more intensively and more constantly. now we have three anesthesiologists on duty in the reception department, a nurse, me with theses, a trainee neurosurgeon, three surgeons, three maxillofacial traumatologists, an ent surgeon, a transfusionist, that is, a full set of doctors who are needed to help the wounded, we receive the wounded

mainly from donetsk oblast but it is also there the wounded who come from kherson region, from mykolaiv region through the hospitals of the kryvyi rih region, zaporizhzhia region and we also send programs, so we have become such a medical hub, a medical center that receives wounded from all over the east, and after providing medical care, after stabilizing the condition, after surgical interventions, we evacuate patients further to central and western ukraine. the corridor when the shelling began and it fell into the yard as if well, in general, something so big fell and i

only remember myself that i was sitting on on the threshold of my skin was completely hanging off my head and my hands were getting more and more. after we left the hospital, i don't remember anything more. they could have been at home. a rocket flew into the yard and my husband is lying on the fifth floor in may. it's also hard. well, people pay here, we send them, and i remember that you're healthy. i'll never be able to forget the story when my grandfather and his 13-year-old granddaughter left mariupol , and in the trunk of the trunk, you were the grandfather he carried everything that was left of his daughter in a cellophane bag, in front of his eyes a rocket

hit their house, he and his granddaughter were left behind alive, but the mother, unfortunately, was not able to hide her here on the ukrainian territory, he took collected everything that was left from the day of kyiv, many of them happen every day, tuesday, it turns out, the husband did not contact me anymore, and i had such a premonition that what happened to him, i was very worried, and on wednesday, it turns out, he contacted me and said . rehabilitation has

already been three operations, and the fourth one will be done now opened at 4:1 in the morning i was at home 9 i was at work and didn't leave here for a month the whole team is alive here very first days there were a lot of refugees when they started bombing kyiv from all the surrounding territories we were equipped with the infrastructure there what is possible for the first sunday it was difficult this and the logistics and the provision of food and the living conditions of the children there was a lot on the second and third day already advice started coming here i go to a young man ego called nazarut my acquaintance turned to eh her own brother and this is friendship for the dawn and they asked me

about help when he was brought here with an injury well, i come with my husband once a week, i try to cook something that is tasty but also useful for me, it is like a child because my son is also 30 years old, and i understand that this is whose child it would also be . we watched how they provide help on the front line, then people stabilize

life is saved, then they are already sent if there is a serious injury to specialized medical institutions where more complex operations are performed, our institution is also where patients are sent to. with all the pathology, it is the lungs, liver, pancreas, and intestines. unfortunately, at the moment, military trauma is such that there is no impression of any one organ. this is mine for explosive injuries that damage the entire body of the entire organism . exceeded this threshold is some wounded

they need four to five to 10 operations, first they fired at a wheat field, then they hit the village, well, and the third one, let's say it's a surprise on the nambu, it's cluster mines, the attack on that dream, the projectile breaks and scatters the mines in a chess order, that is, they are forbidden. well, there is nothing holy in them, just like phosphorus, i am forbidden . well, they are not people, well, orcs are orcs. and hands and that they saved the leg, often this is the first stage before another 4 stages to be passed on to the brother

hello, victory is ours, glory to ukraine, what was amazing, people, after a serious injury , after an operation, the fighters, he only comes to school, he understands what he is, but i’m at the front , my comrades are there, i have guys there, i went to this psychologically prepared to return to the formation, she helped a lot when he was very old. ready to during surgery, the guys put a tourniquet on me, then the doctors put on another tourniquet

, and then they took me all the way to kramatorsk, where we glued it together. of course, everyone's lives changed from february 24, and the life of the surgeons also changed. this will lead to to bone fusion to osteomyelitis, i.e. without prospectively adding a complete complex of tissues, the essence of microsurgery and our approach consists in a free microsurgical transplant or movement of complex tissue complexes on a vascular

pedicle to close an extensive defect. flaps of large sizes 20-25 to 30 cm in length and 10-15 cm in width, which are separated from the vascular pedicle. that is, they are supplied with blood by an artery and a vein, with a diameter of one to 2 mm. the entire flap is cut off from the donor area, moved to the recipient area, and after that we sew on the artery and vein. this operation is planned to take about four hours plus or minus q1 if all these but according to the plan, first we do a revision of the discussions that must be sewn in order to make sure that these vessels can be included in our valve, then if the vessels are suitable

to include classes blood flow we go to the boy's collection, we isolate his vascular pedicle, we isolate his artery and vein, we drain the valve on the zonov site and already move it to the upper limb, where we sew the artery, the event to include which wires well, and then we sew it up at home, see the class was taken from the driver, the operation was involved more than 30 people, this is a collective work, which is then embodied in human life and i understood where i, i immediately fell, well, this is the feeling was that i was somewhere else, as if in the air that

exploded, it is not clear because we passed that everyone came, i was the last to stand and also passed, or maybe something flew or maybe i got caught somewhere, maybe there was some kind of hook there, georgian soldiers could very well be a fisherman there, these hooks catch and you go no, no, you don’t feel he got caught, you went, the explosion was all, well, i fell, i immediately ran up to me, a comrade shouts, don’t look, don’t look, i tell him, look like that, i understand that my leg is torn off, he no, so that you don’t lose consciousness, no, that’s not it you feel normal. even running did not

feel like calling for an evacuation there we needed evacuation and they couldn't leave because the russian tanks started firing somewhere there and told the advisers that they had spotted an enemy helicopter, comrades ran to find our car was on the way, they were fast, did they come to us? -passport , phone, they say everything is fine. he stayed with you, we are here for you. well, i am already i say something and it seems to me that it was possible that we can save my leg. well, when i came to my senses and then i saw that i really don't even have a mental state anymore, i thought, well, what kind of life is more in this life, i was afraid that something like this would happen someday before the war, it's something like how i felt about the burn in me because

i loved it so much where in my life it was football, i practiced it very, very intensively , i went to all kinds of competitions and for some reason i was afraid for right leg well, it's like this for me after six months and it happened. when hostilities started related to the aggression of the russian federation against ukraine, and many wounded patients with combat injuries, including amputations, began to enter us. therefore, in the middle of it, the idea of ​​​​working such a continuum of assistance appeared specifically to treat, rehabilitate and prosthetic ukrainians in ukraine. now, both civilian and military spatulas accept the military due to the fact that , firstly, their number really increased, and

secondly, due to the fact that evacuation routes and such are built in this way the number of military spatulas that there is, it simply cannot accept the number of patients who come to us now, especially since you understand that the evacuation is coming from the east to the safer regions of ukraine, which are calmer. well, as far as it can be said now in this situation, yes, and of course, here we have such a concentration of these patients, that is why the free people in health care institutions should also be able to work with combat trauma and the consequences of combat trauma. and this is another reason why we are creating the

nezlamni ot ruch center ku well you mean passes yes, everything was already done . 3d copy of the patient's stump before the war , it was mainly people after rotation, for example, after diabetes or after a season of diseases. and now most of the work is military personnel after mine explosion injuries or civilians evacuated from temporarily occupied territories. there is a company from the states that does not manufacture er prosthetic hands

. they already make 3d models directly, the process itself in ukraine regarding prosthetics of the upper limb, especially regarding some more specific aspects of prosthetics such as myoelectric prostheses, and with that, a very small number of people in ukraine worked because we simply did not have so many patients, respectively, there was not so much practice and experience and the need for such a number of people who can do it, and therefore well, in fact, the same situation in europe is not because ukraine is there ukraine what is developing is because, in principle, amputation of the upper limb by according to statistics, they have always been much less than the lower limb, and now they have simply tripled in ukraine, and this has greatly burdened the system, the duration of this prosthesis is taking longer, there are not enough components , we have to wait for them from abroad, so it would be a solution for us to have a separate channel for obtaining these components, taking into account our situation and these growing needs that we have, it is very difficult to look at boys who have lost limbs, who need a lot of

rehabilitation efforts. i hope that the guys i will return to a normal, stable life. this is a mobile prosthetics workshop. all manipulations with plastic, layered, or any other, are already carried out here. there is all the necessary equipment in order to, er, engage in thermoforming, assembly of prostheses, as well as er, processing, grinding, smoothing, and the rest. this is a vacuum, er, hmm, a stand, a vacuum pump, that is, because any material is actually used to form plaster, hm, what is it exactly

? well, let's say it took the form of that plaster it must be under a vacuum, and again, our american colleagues came to us and brought us such a fairly new technology, which is, well, which they have in development probably in july of this year. that is, it involves the manufacture of these prostheses for below -the-knee amputations . that is, it is

like this. in well, on roman prostheses rom, that is, and well, there is a kind of cone, you can see it here donat writes open kerhiting, that is, i don’t want to open them now, so that we put this cone in the oven, it heats up and stands up, and it is now quite hard, but it is made after heating, it does not become plastic, plastic, elastic, and we will be able to. when it is already heated, we put it on top of the model and form it already with the help of a vacuum. for a-a people who lost limbs ah and eh, these donors can be very different, they help us with components, and this is the team that also came, an american team, a team from denmark, we had a team from great britain, we also have a rehabilitation team working, we constantly exchange experience, we are improving eh well, of course, they help us with components with certain auxiliary means for rehabilitation, and that is why there are individual people who join its organizations, which join and international partners are countries at the level

of the ministry which support ot but we want more stable this process and say some simplified mechanisms can be supplied to these components that it is a little faster for a good day here is operated on the night yesterday for today he is consciously what they are stable in him combined traumatic traumatic brain and skeletal water with a part of the liga

wounded as civilians such military wounds this is a patient, he remains serious , we had a severe diametrical brain injury, the former underwent surgery to remove a metal foreign body in close fragments, he remains in a superficial coma, a trachesthenia was performed today, it is planned to be evacuated to the city of kyiv, a military hospital, they are much more than 13 years old, it is the doctor's task to operate, make a control computer tomography, see that everything is done correctly, stabilize the patient, and then we will decide. we take from the department of neurosurgery or medals we transfer to the stages of evacuation starting from the 14th year, we do not have such a thing as contraindications to the operation that is not mechnikov, there is no such thing if it were not such a difficult time, but each of the wounded is given a chance to survive and we see miracles indeed, this patient, unfortunately, remains difficult

, he was also operated on in kramatorsk, he has a severe brain injury, removal of brain detritus, focal bruises in the brain, bone fragments, he is also being treated for a superficial coma its temperature is maintained and it stays that way it is unknown, so the first word we want to hear from him sometimes when he is unknown, it is to hear his last name, that is why we approach today we see unknown number two, we are waiting for him to be handed over to us so that he can be stitched up, ask at least his last name by last name, find his family and relatives, it touches more then when their relatives and friends come and you understand what would have happened if they did not save this person, they understand that the injury is severe , that the long rehabilitation may not be good, it will be difficult to speak an arm and a leg will work

. maybe he won't even walk, but you can see

the happiness of the parents of the parents of the children of this wounded man. and indeed, such pride and such a feeling fills the one who saved him with joy. at first he was unknown, then colonel gordiychuk. when he became a major general and a hero of ukraine, it came later. thank you for saving me. i say no, i fell. thank you because you saved the country. and now you are teaching the cadets of the bohun lyceum by example . asked with his wife before that after the interventions many of our patients become our comrades, friends and we communicate with each other. this is the neurosurgery department of the operating center for cerebral neurosurgery. this operating room is open 24 hours a day. from three to seven only uger interventions