Abstract:
Resume. The experience of providing medical care during the antiterrorist operation in eastern Ukraine has shown that in the structure of
modern combat surgical trauma gunshot wounds with soft tissue defects
are 64.9-68.2%, of which 36.4-37.5% small and medium, 28.5-30.7% are
large and very large defects.
Goal: To improve the results of surgical care for soft tissue defects by
introducing differentiated surgical tactics for wound closure to each level.
Material and methods. The total amount of the study was 136 wounded
with shrapnel, bullet and explosive injuries from April 2014 to
September 2018. Determination of surgical tactics for closing soft tissue
defects was performed on the basis of metric classification, taking into
account the area, volume and anatomical areas of the lesion.
Results. The combination of metric characteristics of wound defects by
area, volume and location of wounds in a single classification allowed to
offer a comprehensive approach to sorting the wounded by the level of
medical care and determine further reconstructive surgical tactics to
close soft tissue defects.
Conclusions. The introduction of differentiated surgical tactics in
wounded with gunshot defects of the soft tissues at the all levels of
medical care improved functional results: the proportion of satisfactory
increased from 46.9% to 53.7%, the relative number of unsatisfactory
decreased from 18.8% to 11.6%.
