Clinical and Epidemiological analysis of the structure of combat surgical injury during Antiterrorist operation / Joint Forces Operation

Хоменко, И. П.; Коrol, S. О.; Khalik, S. V.; Shapovalov, V. Yu.; Yenin, R. V.; Нerasimenko, O. S.; Tertyshnyі, S. V.

doi:10.46847/ujmm.2021.2(2)-005

Cited by 26 publications

(15 citation statements)

References 5 publications

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“…На сьогодні вибухові ушкодження виділяють в самостійну категорію сучасної бойової травми. У сучасних збройних конфліктах зростає питома вага невогнепальних травм, зокрема закриті травми [3,4,10].…”

Section: коморбидные заболевания у военнослужащих -участников совреме...unclassified

“…Вибухова травма становила 12,2-50,8%, уражених з нетяжкою бойовою травмою було 36,5%. За локалізацією на бойову травму голови припадало 31,9%, закрита черепно-мозкова травма (ЗЧМТ) зустрічалась у 43,4% бойової нейрохірургічної травми і 12,8-25,2% всієї бойової травми, акубаротравму було діагностовано у 96,1% поранень ЛОР-органів [4,10].…”

Section: коморбидные заболевания у военнослужащих -участников совреме...unclassified

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Comorbidity in Servicemen – Participants of Modern Military Conflicts

Andriy

Olha

Oleksiy

2021

FMEP

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The professional health of a serviceman is the absence of diseases in the presence of a certain level of compensatory and protective mechanisms that ensure high combat effectiveness in the conditions of his professional activity. That is why the most important component of the national security system of our country is the protection and strengthening of the health of military personnel. In recent years, armed conflict has continued in the east of Ukraine. Therefore, today’s urgent task is to study the features of comorbid diseases that may be primary to modern combat trauma in military personnel participating in the anti-terrorist operation / Joint Forces Operation (ATO / JFO). Comorbid diseases have a negative impact on the course of modern combat trauma, as well as combat trauma has a negative impact on the course of these diseases. The objective: to analyze the frequency of comorbid diseases in military personnel – participants in the ATO / JFO, depending on the presence of a closed craniocerebral injury (CTBI). Materials and methods. The study was performed in the Ukrainian Military Medical Academy based on the National Military Medical Clinical Center “Main Military Clinical Hospital” where 183 servicemen – participants of the ATO / JFO with arterial hypertension (AH) were examined. Patients were divided into two statistically homogeneous groups according to age: group I – 127 people who, while participating in the ATO / JFO, did not receive CTBI, group II – 56 people with such injury. Statistical analysis of the results was done by use of the standard statistical package STATISTICA 10.0 for Windows from StatSofr Inc. (USA) using parametric statistical methods. Results. In military personnel participating in the ATO/JFO, there was no correlation between the severity of hypertension and the presence of a cranio-cerebral injury. At the same time, in subjects with CTBI, there was an increase in the frequency of comorbid diseases of the nervous system and diseases of the ear and mammillary process and a decrease in the frequency of comorbid endocrine and metabolic diseases and diseases of the genitourinary system compared to patients without such an injury. Patients with CTBI have an increase in the frequency of acubarotrauma and sensorineural hearing loss and a decrease in the frequency of urolithiasis compared with military personnel without CTBI. Conclusions. The study established the features of comorbid diseases in military personnel – participants in modern military conflicts, depending on the presence of a closed craniocerebral injury. This information is important for the further medical and social rehabilitation and development of proper functional-organizational model of secondary prevention of this comorbid pathology in order to prolong the professional longevity of highly professional military personnel. It is necessary to study further the influence of organic (traumatic) brain lesions over time on the morphogenesis of arterial hypertension and comorbid diseases, and their combination in military personnel participating in the ATO/JFO.

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Section: коморбидные заболевания у военнослужащих -участников совреме...unclassified

Comorbidity in Servicemen – Participants of Modern Military Conflicts

Andriy

Olha

Oleksiy

2021

FMEP

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“…According to the 2014-2019 analysis, limb injuries account for between 52.3% and 60.1% of combat casualties. Gunshot fractures of long bones with widespread soft tissue defects and damage of large blood vessels and nerves occurred in 32.5-39.8% of the injured, and as a component of severe polytrauma, gunshot injuries of the extremities were observed in 67.5-74.4% of the injured [4]. Most of the injured had shrapnel injuries of their limbs (80.4%), of which 70.6% had penetrating, isolated or multiple injuries [5].…”

Section: Introductionmentioning

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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“…Khomenko with co-author. (2021) concluded that in the structure of combat sanitary losses, combat injury to the limbs ranges from 52.3 to 60.1% [1]. Among those wounded in the limb, soft tissue defects requiring plastic closure are present in 64.9-68.2% [2].…”

Section: Introductionmentioning

confidence: 99%

Treatment of Combat Surgical Trauma of the Limbs in the Conditions of Modern War

Trutyak

Los²,

Medzyn³

et al. 2022

Proc Shevchenko Sci Soc Med Sci

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Among the total number of wounded who entered the Military Medical Clinical Center of the Western Region from February to September 2022, combat injury to the limbs was in 63.3%. Bullet wounds caused combat injury to the limbs in 10.4%, shrapnel and mine-explosive – in 68.1%, explosive injury – in 21.5%. At the second role of medical care, emergency surgical interventions were performed on the wounded, immobilization of bone fractures with an external fixation and anti-shock therapy. At the third and fourth roles – the treatment of the wounded consisted in the use of a multidisciplinary approach with the involvement of doctors of various specialties, first of all, general surgeons, traumatologists, vascular, plastic surgeons and anesthesiologists. The most frequent surgical intervention was repeatened and secondary debridment of gunshot wounds, which was required by 93% of the wounded. The main pathogens that vegetated in wounds were Acinetobacter baumannii, Pseudomonas aeruginosa, Enterobacter aerogenes, Proteus vulgaris, Enterococcus faecalis with high levels of microbial contamination – 104-108/g in tissues., Various types of plastics were used to close soft tissue defects, according to the rule of the reconstruction ladder. After healing a soft tissue wound to determine the timing of replacing the method of fixing fractures with internal osteosynthesis, were analyzed clinical and laboratory parameters and assessed the risks of complications. The main causes of amputations of the limbs were common defects in soft tissue and bones, which were not subject to reconstruction with no prognosis for bone fusion and progression of the infectious-necrotic process.

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Clinical and Epidemiological analysis of the structure of combat surgical injury during Antiterrorist operation / Joint Forces Operation

Cited by 26 publications

References 5 publications

Comorbidity in Servicemen – Participants of Modern Military Conflicts

Comorbidity in Servicemen – Participants of Modern Military Conflicts

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

Treatment of Combat Surgical Trauma of the Limbs in the Conditions of Modern War

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