ZAPORIZHZHIA STATE MEDICAL AND PHARMACEUTICAL UNIVERSITY, ZAPORIZHZHIA, UKRAINE.
ZAPORIZHZHIA MILITARY HOSPITAL, ZAPORIZHZHIA, UKRAINE.
Wiad Lek. 2023;76(5 pt 2):1227-1232. doi: 10.36740/WLek202305214.
The aim: To highlight the original experience of diagnosis and treatment of patients with gunshot wounds of the extremities with extensive defects of the soft tissues.
Materials and methods: The total number of treated patients with massive gunshot wounds from February 2022 to March 2023 was 60 males. Basic labo¬ratory tests, X-rays of the affected limbs were performed to all patients. USS of the vessels with color Doppler was performed to those casualties who had no peripheral pulses on the wounded extremity. All injured persons underwent wound debridement and fasciotomy on the day of admission, 8 more casualties underwent surgical interventions on the major vessels and nerves.
Results: Good treatment outcomes for patients with extensive soft tissue injury were achieved by early surgical intervention to remove non-viable tissue. Limb preservation was achieved in 98.3% of cases.
Conclusions: The study's conclusion emphasizes the importance of a multidisciplinary approach to treating patients with gunshot wounds to the limbs with extensive soft tissue injury. Early surgical interventions with the removal of non-viable tissues are necessary for good outcomes. Revascularization of the affected limb is essential in case of major vessel injury if there is no thread to the life.
强调诊断和治疗四肢广泛软组织缺损的枪伤患者的原始经验。
2022 年 2 月至 2023 年 3 月，共收治 60 名男性严重枪伤患者。对所有患者均进行了基本实验室检查和受影响肢体的 X 射线检查。对受伤肢体无外周脉搏的伤员进行了带彩色多普勒的血管超声检查。所有受伤人员在入院当天进行了清创和筋膜切开术，另外 8 名伤员接受了主要血管和神经的手术干预。
通过早期手术干预去除无活力组织，实现了广泛软组织损伤患者的良好治疗效果。98.3%的病例实现了肢体保留。
研究结论强调了多学科方法治疗四肢广泛软组织损伤的重要性。早期手术干预去除无活力组织是取得良好效果的必要条件。如果没有通向生命的通道，在主要血管损伤的情况下，受影响肢体的血运重建是必要的。
