The modern concept of diagnosis and treatment of gunshot and mine-explosive injuries of limbs

Loskutov, Oleg; Zarutskiy, Yaroslav

doi:10.15674/0030-5987201625-9

Cited by 5 publications

(3 citation statements)

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“…Mechnikov" during the period from 24.02.22 to 15.04.22. The hospital corresponds to Level III of medical care and a specialized medical evacuation phase, where the trauma and orthopedic surgery department mainly performs secondary surgical debridement of wounds, comprehensive surgical and medical prevention of complications in the injured [11]. The mean age of the injured was (M±SD) 37.0±6.2 years.…”

Section: Methodsmentioning

confidence: 99%

The Use of “Damage Control Orthopedics” Strategy in the Treatment of Severe Gunshot Wounds of the Limbs

2023

BSCR

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Objectives: The objectives of this study were to evaluate the incidence and nature of gunshot wounds of the limbs in the general structure of combat trauma, and study the features of DCO (Damage Control Orthopedics) patient management strategy in the conditions of a regional hospital as a stage of care for this pathology. Background: Limb injuries account for between 52.3% and 60.1% of combat casualties. The problem of surgical management of limb gunshot wounds is of particular relevance at the present stage of active use of firearms. Thus, adequate choice of surgical treatment strategy for limb gunshot wounds is an important condition for preserving life and preventing severe complications in combat casualties. Methods: The study was conducted among 1000 injured from the combat zone during the period from 24.02.22 to 15.04.22. The trauma and orthopedic surgery department of “Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov” mainly performed secondary surgical debridement of wounds, comprehensive surgical and medical prevention of complications in the injured. Injury severity was assessed using the ISS (Injury Severity Score) based on the AIS (Abbreviated Injury Scale), which assesses the severity of injuries to several areas of the body. Results: DCO strategy was used in 287 (55.1%) injured patients in severe and extremely severe condition (16 points or higher on the ISS scale). A total of 602 surgical operations were performed in 287 injured patients. On average, 2.1±0.6 interventions per one injured person were performed. Overall mortality among victims with gunshot wounds of the limbs was 3.6% (19 wounded out of 521). In all cases there were polytrauma (100%), in 4 (21.1%) cases they were through-and-through injuries, in 2 (10.5%) - with the compartment syndrome development. Conclusions: Differentiated DCO strategy in the surgical treatment of the critically and severely injured (16 points and above on the ISS scale) are essential to save the lives of soldiers in the first period of traumatic illness and to prevent complications of the second and third periods of traumatic illness

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Section: Methodsmentioning

confidence: 99%

The Use of “Damage Control Orthopedics” Strategy in the Treatment of Severe Gunshot Wounds of the Limbs

2023

BSCR

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“…Тому дуже бажано, щоб санація рани проводилася в межах перших 6 годин після поранення [1]. Окрім часового терміну, в який проводиться первинна хірургічна обробка рани, велике значення мають і якість та обсяг проведених заходів, логістика подальшого спостереження, діагностики та лікування, якість перев'язок та післяопераційного догляду, чітке розуміння плану лікувально-профілактичних заходів та послідовності евакуації пораненого і ще багато інших важливих факторів [2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: вступunclassified

“…За даними медичного департаменту МО України, в структурі вогнепальних травм у період 2016-2017 pp. 64% належали пораненням кінцівок (74,8% -м'які тканини) [14]. А в структурі незадовільних результатів лікування вогнепальних переломів провідне місце належить інфекційним ускладненням -32,1% (18,1% -хронічний остеомієліт).…”

Section: обговоренняunclassified

Treatment Tactics in Case of Infectious Complications in Patients with Combat Injuries of the Musculoskeletal System (according to the Clinic’s Own Experience)

Hrytsai,

Poliachenko,

Tsokalo

et al. 2023

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Background. The successful treatment of combat wounds should be based on strict scientific principles, based not only on the time limits for successful wound healing, but also on the quality and scope of the measures taken, the logistics of follow-up, diagnosis and treatment, the quality of dressings and postoperative care, and a clear understanding of the treatment plan – preventive measures and sequence of evacuation of the wounded. Objective: to determine the scope and choice of optimal treatment tactics for combat injuries in patients during the war in Ukraine since 2014, who had infectious complications from the musculoskeletal system. Materials and Methods. The medical histories of patients who were treated with infectious complications at the clinic of bone-purulent surgery of the SI "Institute of Traumatology and Orthopedics of NAMS of Ukraine" from 2014 to mid2022 were analyzed. Results and Conclusions. The treatment of infectious complications of a combat injury is more intensive, protracted, and more costly in terms of resources and material. The plan covers staged treatment using various surgical procedures and techniques.

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The Use of “Damage Control Orthopedics” Strategy in the Treatment of Severe Gunshot Wounds of the Limbs

Domanskyi

Tomilin

2023

Preprint

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Objectives. The objectives of this study were to evaluate the incidence and nature of gunshot wounds of the limbs in the general structure of combat trauma, and study the features of DCO (Damage Control Orthopedics) patient management strategy in the conditions of a regional hospital as a stage of care for this pathology. Background. Limb injuries account for between 52.3% and 60.1% of combat casualties. The problem of surgical management of limb gunshot wounds is of particular relevance at the present stage of active use of firearms. Thus, adequate choice of surgical treatment strategy for limb gunshot wounds is an important condition for preserving life and preventing severe complications in combat casualties. Methods. The study was conducted among 1000 injured from the combat zone during the period from 24.02.22 to 15.04.22. The trauma and orthopedic surgery department of "Dnipropetrovsk Regional Clinical Hospital named after I.I. Mechnikov" mainly performed secondary surgical debridement of wounds, comprehensive surgical and medical prevention of complications in the injured. Injury severity was assessed using the ISS (Injury Severity Score) based on the AIS (Abbreviated Injury Scale), which assesses the severity of injuries to several areas of the body. Results. DCO strategy was used in 287 (55.1%) injured patients in severe and extremely severe condition (16 points or higher on the ISS scale). A total of 602 surgical operations were performed in 287 injured patients. On average, 2.1 ± 0.6 interventions per one injured person were performed. Overall mortality among victims with gunshot wounds of the limbs was 3.6% (19 wounded out of 521). In all cases there were polytrauma (100%), in 4 (21.1%) cases they were through-and-through injuries, in 2 (10.5%) - with the compartment syndrome development. Conclusions. Differentiated DCO strategy in the surgical treatment of the critically and severely injured (16 points and above on the ISS scale) are essential to save the lives of soldiers in the first period of traumatic illness and to prevent complications of the second and third periods of traumatic illness.

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The modern concept of diagnosis and treatment of gunshot and mine-explosive injuries of limbs

Cited by 5 publications

References 0 publications

The Use of “Damage Control Orthopedics” Strategy in the Treatment of Severe Gunshot Wounds of the Limbs

The Use of “Damage Control Orthopedics” Strategy in the Treatment of Severe Gunshot Wounds of the Limbs

Treatment Tactics in Case of Infectious Complications in Patients with Combat Injuries of the Musculoskeletal System (according to the Clinic’s Own Experience)

The Use of “Damage Control Orthopedics” Strategy in the Treatment of Severe Gunshot Wounds of the Limbs

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