Authors
Levchuk A.L., Ignatiev T.I., Chevais A.
Pirogov National Medical and Surgical Center, Moscow
Abstract
Purpose: to improve the results of surgical treatment of soft tissue gunshot wounds caused by modern combat wounding agents taking into account the prognostic factors of traumatic disease course.
Methods: the results of complex treatment of 112 patients with soft tissue gunshot wounds were analyzed. From them 83,9% of the injured had combined and multiple gunshot wounds. The study included the wounded, in whom the area of the wound channel or damage amounted to 10 cm2, after primary surgical treatment at the previous stages of medical evacuation. Traumatic (wound) disease was diagnosed in 39 (34.8%) wounded.
Result: purulent-septic complications were diagnosed in 88% of the investigated patients. All the victims were treated by complex general clinical and local treatment with observance of the basic principles of surgical interventions (initial surgical debridement, second surgical debridement), vacuum-aspiration therapy and medicamentous application of modern water-soluble ointments in the I phase and ointments on regulated osmotic basis in the II phase of the course of the wound process. Pathogenetically substantiated multicomponent intensive therapy was required for 47 wounded, who received antibacterial treatment, immunotherapy, antibacterial detoxication, replenishment of protein-energy and water-electrolyte disorders. Complicated course of the wound process was noted in 13% of the victims, there were no lethal outcomes.
Keywords: gunshot wound, infectious complications, modern principles of treatment.
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