Limbs Reamputations in Military Personnel Injured in the Area of the Antiterrorist Operation in East Ukraine

Bespalenko, A.A.; Buryanov, A.A.; Tsema, Ie. V.; Dinets, Andrii

doi:10.32345/usmyj.1(105)().2018.5-10

Cited by 2 publications

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“…Amputations were performed three times more often on the lower extremities [4]. During the 2014-2016 antiterrorist operation in the East of Ukraine, the frequency of amputations among service members of the Armed Forces of Ukraine was 2.2%, excluding data from other law enforcement agencies [5].…”

Section: Introductionmentioning

confidence: 99%

Problematic Issues of Limb Amputation in Wounded With Combat Trauma

Trutyak,

Malickii,

Samotowka

et al. 2023

Proc Shevchenko Sci Soc Med Sci

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Among the wounded with limb injuries admitted to the Military Medical Center of the Western region during the year of Russia’s full-scale war in Ukraine, 29% had a mine-blast injury, 47% had shrapnel wounds, 8% had gunshot bullet wounds, 1.5% – thermal injuries, and14.5% – traumatic injuries. Upper limbs were injured in 22%, lower – in 32%, 15% had two limbs injured, and 31% had combined combat trauma. In all hospitalized with multi-fragment fractures, limbs were fixed with external fixation devices. 2% of patients had vascular damage. All wounded had unhealed wounds with a soft tissue defect. The average age of patients was 30 years. There were no comorbid diseases in the wounded, and concomitant diseases that did not affect the course of injury were found in 10%. Amputations of limbs were performed in 6.5%. Traumatic separation of a limb segment or its destruction with crushed bone and non-viable soft tissues, nerve damage with significant defect, soft tissue and bone defect, as well as thermal ischemia of the limb for more than 6 hours with necrosis of its soft tissues, were indications for primary limb amputation in 3% of wounded and injured, which were in the nature of primary debridement. Progressive wound infection with the development of the septic condition of the wounded despite intensive treatment, total ischemic necrosis, and recrudescent arrosive bleeding from great vessels required a secondary limb amputation in 1.5%. In 1.5% of the wounded, staged operations were performed as re-amputations. Re-amputation had to be performed in 0.6% of patients with an inappropriate limb stump level, which complicated prosthetics. To reduce the number of amputations for secondary indications, a timely diagnosis is needed of compartment syndrome and rational treatment of soft tissue wounds and gunshot fractures with surgical and medical prevention of the infectious process.

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Section: Introductionmentioning

confidence: 99%

Problematic Issues of Limb Amputation in Wounded With Combat Trauma

Trutyak,

Malickii,

Samotowka

et al. 2023

Proc Shevchenko Sci Soc Med Sci

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The First Stage Reconstruction of the Soft Tissue Defects of Gunshot Wounds

Хоменко¹,

Гуменюк²,

Tsema³

et al. 2020

RS Global - Web of Scholar

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The aim. To investigate and used a multimodal diagnostic scheme during the first stage of reconstructive surgical treatment of wounded with soft tissue defects at the second level of medical care.Materials and methods. By identifying thermographic areas with gunshot wounds of the soft tissues, we observed at the second level of medical care during 4 months of 2020 (from March to July) 37 cases.Results. We used a multimodal scheme in the pre-, intra- and postoperative period helps to reduce the area of defects in 23 (62.2%) cases out of 37 against the background of restoration and preservation of microcirculation in the damaged structure, and the number of subjectively unsatisfactory military personnel in 4 (12.8%) of the total the number of wounded, a decrease in the loss of functional ability in 19 (51.2%) cases.Conclusions. The combination of dynamic digital thermography in combination with an audio doppler at the second level of medical care can improve the quality of primary surgical treatment by performing surgery with clear indications of the proposed technique; maintain a larger volume of viable tissues, reduce the area of the defect and the number of complications in the further treatment of the wounded.

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Limbs Reamputations in Military Personnel Injured in the Area of the Antiterrorist Operation in East Ukraine

Cited by 2 publications

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Problematic Issues of Limb Amputation in Wounded With Combat Trauma

Problematic Issues of Limb Amputation in Wounded With Combat Trauma

The First Stage Reconstruction of the Soft Tissue Defects of Gunshot Wounds

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