Mellin Ruslan, Velichko Ellina, Maltseva Larisa, Dydykin Sergey, Vasil'ev Yuriy
G. Ya. Remishevskaya Republican Clinical Hospital, Abakan 655012, Russia.
Pathological Physiology Department, I.M. Sechenov First Moscow State Medical University, Moscow 119435, Russia.
Healthcare (Basel). 2024 Feb 24;12(5):542. doi: 10.3390/healthcare12050542.
Injuries to humans caused by wild animals, particularly bears, are rarely mentioned in the literature. Such injuries are frequent in Siberia, which is a territory surrounded by dense forests inhabited by brown bears. In the last 4 months alone (September-December 2023), four bear attacks on humans were registered in Khakassia, Russia. This article presents a clinical case of rehabilitating a patient after a bear attack, who suffered multiple fragmentary fractures of the facial skeleton with displaced bone fragments, subcutaneous emphysema of the soft tissues of the face, damage to the parietal and right occipital regions and paranasal sinus hemorrhage on the left side. The nature of the injuries was enhanced by trauma to the upper extremity caused by the patient defending himself against the animal. In addition to the damage to his face, the bear tried to open his cranium, as evidenced by four furrows caused by its canines, including two each on the frontal and occipital bones of the skull. The patient's complex treatment included both maxillofacial and reconstructive surgeries, and outpatient treatment involved the formation of normotrophic scars using a neodymium laser and injections of a heterogeneous composition consisting of microparticles of "crosslinked" collagen of animal origin placed in a gel identical to the natural extracellular matrix.
野生动物，尤其是熊对人类造成的伤害在文献中很少被提及。在西伯利亚，这类伤害很常见，该地区被棕熊栖息的茂密森林环绕。仅在过去4个月（2023年9月至12月），俄罗斯哈卡斯就记录了4起熊袭击人类的事件。本文介绍了一名熊袭击受害者康复的临床病例，该患者面部骨骼多处粉碎性骨折且骨碎片移位，面部软组织皮下气肿，顶叶和右枕叶区域受损，左侧鼻窦出血。患者为抵御动物而造成的上肢创伤加重了损伤的程度。除了面部损伤外，熊还试图打开他的颅骨，颅骨上有四条犬齿造成的沟痕可以证明，其中两条在额骨，两条在枕骨。患者的综合治疗包括颌面外科手术和重建手术，门诊治疗包括使用钕激光形成正常营养性瘢痕，以及注射一种由动物源性“交联”胶原微粒组成的异质组合物，该微粒置于与天然细胞外基质相同的凝胶中。
