Proceeding from retrospective analysis of 1802 casualties presenting open and closed combined trauma (CT), treated in the Emergency Medicine Institute "Pirogov" over the period 1985 through 1994, attention is focused on the changes in incidence and patterns of associated injuries. Problems relating to organization of the treatment of such patients at the various stages are discussed. The basic requirements of diagnosing and establishing the indications for operation are outlined from the standpoint of general surgery. Finally, the main developmental trends of the therapeutic approach to CT, and the possible ways to find a solution of the most important problems along this line are summed up.

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