Stanec Z, Skrbić S, Dzepina I, Hulina D, Ivrlac R, Unusić J, Montani D, Prpić I
Department of Surgery, School of Medicine, University of Zagreb, Croatia.
Ann Plast Surg. 1993 Aug;31(2):97-102. doi: 10.1097/00000637-199308000-00001.
In this article, we emphasize that knowledge of terminal ballistics is essential for understanding the pathophysiology of war wounds. We present our own experiences in treatment of high-energy war wounds in 75 patients treated in the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center in Zagreb. Patients were divided into three groups with regard to the time of definite reconstruction, using local or free microvascular flaps. About 12% of patients underwent flap reconstruction in the acute phase, associated with low complication rate and the shortest hospital stay. Group II was comprised by 18% of the patients and, considering the number of complications, presented the most unfavorable time for reconstruction. Flap reconstruction in the chronic phase resulted in a substantial prolongation of the hospital stay in 82% of patients. Therefore, we advocate proper primary treatment of wounds aimed at early flap closure. This type of management results in a significantly shorter hospitalization and leads to more effective rehabilitation and recovery of patients.
在本文中，我们强调终点弹道学知识对于理解战伤的病理生理学至关重要。我们介绍了在萨格勒布临床医院中心外科整形与重建外科研究所治疗的75例高能战伤患者的治疗经验。根据使用局部或游离微血管皮瓣进行确定性重建的时间，将患者分为三组。约12%的患者在急性期接受皮瓣重建，并发症发生率低且住院时间最短。第二组占患者的18%，从并发症数量来看，这是重建最不利的时间。慢性期皮瓣重建导致82%的患者住院时间大幅延长。因此，我们提倡对伤口进行适当的初期治疗，目标是早期闭合皮瓣。这种治疗方式可显著缩短住院时间，并使患者得到更有效的康复和恢复。
