1National Military Medical Clinical Center «Main Military Clinical Hospital», Kyiv, Ukraine.
2Ukrainian Military Medical Academy, Kyiv, Ukraine.
Georgian Med News. 2023 May(338):117-120.
The article is devoted to the development of a strategy for reconstructive interventions in wounded after gunshot injuries of the hand with tissue defects, which will improve the anatomical and functional results. During the period from 2019 to 2020, 42 plasty of soft tissue defects of the hand (39 patients) with the use of rotary flaps on perforating and axial vessels were performed in the trauma department of the injury clinic of the National Military Medical Clinical Center «Main Military Clinical Hospital» for plasty of soft tissue defects of the hand, a radial flap was used in 15 (36%), a rotational dorsal forearm flap in 15 (36%), and an insular neurovascular flap in 12 (28%). Evaluation of the immediate (3 places after surgery) and long-term (1 year after surgery) results of treatment of patients with soft tissue defects of the hand who underwent flap transposition, according to the Disability of the arm, shoulder, and hand outcome measure scale (DASH) showed an average value of 32,0 (after 3 months) and 29,4 (after 1 year), which corresponds to good functional results of treatment. The main principle of successful treatment of gunshot wounds is the implementation of primary, repeated surgical treatments followed by early closure of defects. The main factors that determine the surgical tactics are localization, area, and volume of the wound defect.
本文致力于制定手部创伤后伴有组织缺损的枪伤患者的重建干预策略，以改善解剖和功能结果。在 2019 年至 2020 年期间，在国家军事医学临床中心“主要军事临床医院”创伤科对手部软组织缺损进行了 42 例旋转皮瓣成形术（39 例患者），用于手部软组织缺损的成形术，其中使用了 15 个桡侧皮瓣（36%）、15 个旋转前臂背侧皮瓣（36%）和 12 个岛状神经血管皮瓣（28%）。根据手臂、肩部和手部功能障碍评定量表（DASH）评估手部软组织缺损患者皮瓣移位的即刻（手术后 3 处）和长期（手术后 1 年）治疗效果，平均分值为 32.0（3 个月后）和 29.4（1 年后），这表明治疗的功能结果良好。成功治疗枪伤的主要原则是实施一期、重复的手术治疗，随后早期闭合缺损。决定手术策略的主要因素是伤口缺损的定位、面积和体积。
