Healing features of experimental injuries of soft tissues that contain foreign bodies in the form of fragments of military personnel uniforms

Pavlov, Sergey; Litvinova, O. B.; Mikhaylusov, R.N.; Negoduyko, V. V.; Kumetchko, Marina; Semko, N

doi:10.1136/bmjmilitary-2020-001666

Cited by 3 publications

(2 citation statements)

References 31 publications

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“…A more pronounced inflammatory reaction was characterized by a group of animals with implanted tissue fibers consisting of 100% cotton. According to a semiquantitative analysis published in our previous work, 20 the number of polymorphonuclear leukocytes in this group was 1.6 times higher at a period of 15 days, 3.1 times after 1 month, and 9.6 times after 2 months compared with the control group ( P < .05). The dynamics of changes in the number of fibroblasts, vessels, and collagen reflected a slowdown in the growth and maturation of granulation tissue in the experimental groups, especially in group 1.…”

Section: Discussionmentioning

confidence: 53%

“…The number of polymorphonuclear leukocytes in this group was 1.6 times higher at 15 days, 2.7 times after 1 month, 5 times after 2 months, compared with the control group ( P < .05). 20 By the end of the experiment, the implants were isolated from the surrounding tissues and “immobilized” by dense connective tissue membranes and layers in the capsule. This minimized the trauma of the muscles during movement and contact with the internal environment of the body, which reduced the possibility of reactivating the processes of inflammation.…”

Section: Discussionmentioning

confidence: 99%

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The influence of foreign textile bodies from military clothes on the healing process of experimental injuries of soft tissues

Mikhaylusov

Negoduyko²,

Pavlov

et al. 2022

Porto Biomedical Journal

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Background: The healing of combat wounds can be complicated by the presence of foreign bodies, including fragments of military clothing. The present work aims to study the morphological features of soft tissue injuries with textile fibers implanted into wounds, personnel military forms during wound healing, in the experiment.Methods: By randomization, 54 rats were divided into 3 groups. Control group animals performed a layer-by-layer incision of soft tissues without implantation of foreign bodies. Animals of the experimental group 1 were made implantation of fibers of a fabric consisting of 100% cotton, and of the experimental group 2-of fibers of a fabric consisting of 65% cotton and 35% polyester. Removal of laboratory animals from the experiment was carried out on the 15th, 30th, and 60th day. Soft tissue samples were histologically examined.Results: The least pronounced inflammation was observed in rats of the control group. Wound healing in the experimental groups was slowed down due to the presence of inflammatory foci. A more pronounced inflammatory reaction was characterized by a group of animals with implanted tissue fibers consisting of 100% cotton. In the group with implanted tissue fibers consisting of 65% cotton and 35% polyester, the inflammatory reactions were less pronounced.Conclusions: The presence of textile foreign bodies hampers the healing process of wounds of soft tissues due to the developing processes of inflammation around foreign bodies. The uniform of servicemen (35% synthetic and 65% natural fiber) is less reactive, leaving a wound as a textile foreign body, and has a less pronounced inflammatory effect, apparently due to the presence of synthetic threads that are more inert compared to fabric containing 100% natural fiber. This confirms the need for thorough debridement of combat wounds during the primary surgical treatment.

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Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

The influence of foreign textile bodies from military clothes on the healing process of experimental injuries of soft tissues

Mikhaylusov

Negoduyko²,

Pavlov

et al. 2022

Porto Biomedical Journal

Self Cite

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Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)

Beley,

Loskutov,

Strokan

et al. 2024

ЕМ

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Background. Infectious complications remain one of the main causes of mortality and morbidity in blast injury among military personnel. The prevalence of infectious complications in blast injury reaches 35 %, and often the causative agents of such infections are multidrug-resistant microorganisms. The purpose was to analyze the dynamics of causative agents of wound infections in military personnel during the full-scale russian invasion. Materials and methods. We conducted a retrospective cohort study of servicemen who were injured during hostilities and were treated at the Feofaniya Clinical Hospital from March 2022 to March 2024. Wound culture was mandatory for study inclusion. Samples were taken from wounds with signs of inflammation, and microbiological testing was carried out in the laboratory of Feofaniya Clinical Hospital. Cultures were conducted in accordance with standard methods of medical microbiology. The disc diffusion method was used to determine the sensitivity of isolates to antimicrobial drugs. Results. The study included 478 servicemen (mean age of 36.60 ± 0.42 years, range 18–67, 99.6 % were males) who have had 1441 wound cultures, and 2483 isolates were identified. No pathogen was detected in 289 cases (11.63 %), fungal isolates were detected in 59 (2.38 %) cases, and the remaining isolates (2135; 85.98 %) were found to be bacterial. Gram-negative flora predominated among them — 80.2 % (95% confidence interval (CI) 78.4–81.8), while Gram-positive flora accounted for 19.8 % (95% CI 18.2–21.6), p < 0.001. The most common pathogens were Klebsiella pneumoniae (22.8 %; 95% CI 21.2–24.5), Acinetobacter baumannii (20 %; 95% CI 18.5–21.6), Pseudomonas aeruginosa (13.6 %; 95% CI 12.3–14.9) and Enterococcus spp. (6.2 %; 95% CI 5.3–7.2). Other pathogens were observed with a proportion of < 5 %. Monomicrobial cultures accounted for 50.5 % (95% CI 47.8–53.3), two isolates were found in 34.0 % (95% CI 31.4–36.6), three isolates — in 12.7 % (95% CI 10.9–14.5), four isolates — in 2.2 % (95% CI 1.4–3.0) and five isolates — in 0.6 % (95% CI 0.3–1.1) of all cultures. There was a significant level of antibiotic resistance — 99.7 % of Klebsiella pneumoniae isolates were multidrug-resistant. Conclusions. Wound infection in blast injury is characterized by a significant predominance of Gram-negative microflora with a high prevalence of antibiotic resistance. Polymicrobial flora was identified in half of the cases of wound infection.

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A clinical case of using the concept of monitoring in the treatment of a gunshot defect of the soft tissues of the knee joint

Лурін

Хоменко

Khoroshun³

et al. 2023

Med. perspekt.

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Rapid rehabilitation and restoration of the function of damaged anatomical areas in the military is the main goal of military medicine. In the case of gunshot wounds of the knee joint with defects of soft tissues, one of the optional methods of reconstructive and plastic "closure" is the usage of a propeller flap. The clinical case represents a mine-explosive wound of the lower extremities with a defect of the soft tissues of the lateral aspect of the right knee joint in a serviceman of the Ukrainian Armed Forces as a result of artillery shelling in the east of Ukraine in November 2022. There was an isolated shrapnel tangential non-penetrating wound on the lateral aspect of the right knee joint with a soft tissue defect measuring 7.2x3.2-1.0 cm. The aim of the work was to study the thermographic and sonographic features of soft tissue perfusion after gunshot injuries of the lower extremities and on the basis of the temperature dynamics data from the wound surface in combination with the sonographic examination of the vessels to determine the rationality and relevance in the reconstruction of defects of the lower extremities by propeller tactics. Reconstruction with flap with a perforating vessel as the "key" of LSGA (lateral superior genicular artery) and a dynamic multimodal concept (DMT) with the use of audio doppler in the pre-, intra- and postoperative period) with closure of the defect due to a rotary perforating flap with supplying was carried out. During the entire period of treatment, of the injured the temperature background from the surface of the flap was followed up using FLIR C2, and sonographic changes in blood flow were monitored in the projection of the LSGA location. We came to the conclusion that applying the technique of flaps on perforating vessels, several goals are tactically achieved: restoration of the completeness and function of the damaged area, reduction of complications in the recipient and donor areas. Thus, the propeller flap can be classified as a primary option for "replacemen t" of tissues among the restorative tactics of the damaged area of the lower extremities caused by a gunshot origin.

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Healing features of experimental injuries of soft tissues that contain foreign bodies in the form of fragments of military personnel uniforms

Cited by 3 publications

References 31 publications

The influence of foreign textile bodies from military clothes on the healing process of experimental injuries of soft tissues

The influence of foreign textile bodies from military clothes on the healing process of experimental injuries of soft tissues

Evolution of the microbiota of wound infections in military personnel during the full-scale russian invasion: a retrospective cohort study (2022–2024)

A clinical case of using the concept of monitoring in the treatment of a gunshot defect of the soft tissues of the knee joint

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