I Introduction. In generalizing the experience of providing medical care to the wounded in armed conflicts, a special place belongs to the analysis of the magnitude and structure of casualties, which depend on the conditions, forms and methods of hostilities. The purpose. Conduct a clinical and epidemiological analysis of the proportion of gunshot and mine injuries in the structure of combat surgical trauma during the Anti-terrorist operation / Joint Forces operation. Materials and methods. The total number of wounded as a result of the armed conflict in eastern Ukraine in the period from 2014 to 2019 was more than 41 thousand people, from them killed among the civilian population – 3350 people and 4100 – servicemen. Results. It was proved that the wounded with non-severe combat surgical trauma are 36.5%, severe – 48.9%, extremely severe – 14.6%. Shrapnel wounds were received by 35.3%, bullet wounds – 48.3%, mine injuries – 16.6%. Isolated combat surgical trauma was found in 16.8%, multiple – in 34.3%, combined – in 48.9% of the wounded. Impenetrable combat surgical trauma was diagnosed in 63.7% of the wounded, penetrating into the pleural cavity – in 17.2%, in the abdominal cavity – in 16.0%, in the pelvic cavity – in 3.1%. Conclusions. In the structure of sanitary losses of the surgical profile during the ATO / OOS, the wounded with injuries of the extremities are 56.7%, with injuries of the chest – 10.1%, abdomen – 5.1%, pelvis – 3.0%.
The use of these traditional peacetime methodological approaches to accounting and analysis of non-combat injuries has led to an underestimation of its high level in the planning of inpatient care for servicemen of the Armed Forces of Ukraine in the area of the Joint Forces operation (anti-terrorist operation). The purpose of the study is a general assessment of the place of combat and non-combat injuries (including poisoning) in the structure of cases of hospitalization of servicemen of the Armed Forces of Ukraine in the area of the Joint Forces operation and anti-terrorist operation. Statistical mathematical processing was performed using computer programs Microsoft Excel and STATISTICA (version 6, StatSoft, Inc.). Based on annual medical reports on 3/med form, the ICD-10 structure of Ukrainian Armed Forces servicemen treated in MTF located in area of Joint Forces Operation for 2015-2020 has been presented. Ranks of disease classes have been calculated. Based on medical reports according Temporary instruction on codification of battle injures, non-battle trauma and diseases in Ukrainian Armed Forces, the structure of casualties admissions to MTF have been pointed out. The leading places in structure of treated servicemen belongs to patients with diagnoses on XIX class of ICD-10 (1st place for 2015-2019, 2nd place in 2020) that was stipulated by relative high levels of non-battle trauma in troops on the East of Ukraine. The comparison of structure of servicemen treated in MTF located in and out area of Joint Forces Operation as well as with structure of adult population (over 18 years old) treated in civil hospitals has been conducted. Prevalence of traumatic pathology levels among patients treated in MTF located in area of Joint Forces Operation in comparison with others treatment facilities data has been revealed. For 2015-2020 the shares of trauma and poison cases in structure of treated servicemen in MTF located in area of Joint Forces Operation significantly decreased that was connected with gradual lowing of battle actions intensity and non-battle trauma level. Based on result of research the necessity to improve curative and diagnostic base of military treatment facilities in area of Joint task operation as well as medical report and non-battle trauma prevention systems has been concluded.
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