Danić D, Prgomet D, Milicić D, Leović D, Puntarić D
Department of Otorhinolaryngology and Cervicofacial Surgery, Dr Josip Bencević General Hospital, Slavonski Brod, Croatia.
Mil Med. 1998 Feb;163(2):117-9.
During the 1991-1992 war in Croatia, 7,043 wounded persons were treated at Dr Josip Bencević General Hospital in Slavonski Brod. Among them, 728 (580 soldiers and 148 civilians) had war injuries to the head and neck and were admitted to the Department of Otorhinolaryngology and Cervicofacial Surgery. There were 541 (74.3%) patients with head injuries, 117 (16.0%) with neck injuries, and 70 (9.6%) with a combination of head and neck injuries. The wounds were mostly inflicted by shell and bomb fragments (542 wounds, or 74.5%). War injuries of the facial bones were preliminarily or definitively treated. Preliminary treatment was used for the wounds with multifragmentary fractures and extensive soft-tissue defects. Definitive treatment was used in lesions of cervical structures. Immediate exploration of the neck was performed on 84 patients with penetrating neck wounds. Exploration was positive in 49 patients. Concerning long-term complications, two cases of partial paralysis of the cranial plexus and one case each of quadriplegia, hemiplegia, and glottic paralysis were recorded. To our knowledge, primary closure of war wounds to the head and neck (supported by antibiotic therapy) and reconstruction of extensive laryngotracheal injuries with the medial layer of the cervical deep fascia were used for the first time as war surgery procedures.
在1991 - 1992年克罗地亚战争期间，斯拉沃尼亚布罗德的约西普·本采维奇综合医院共收治了7043名伤员。其中，728人（580名士兵和148名平民）头部和颈部有战伤，被收治于耳鼻咽喉头颈外科。有541名（74.3%）患者头部受伤，117名（16.0%）颈部受伤，70名（9.6%）头部和颈部联合受伤。伤口大多由炮弹和炸弹碎片造成（542处伤口，占74.5%）。对面部骨骼的战伤进行了初步或确定性治疗。对于多发骨折和广泛软组织缺损的伤口采用初步治疗。对于颈部结构损伤采用确定性治疗。对84例穿透性颈部伤口患者立即进行了颈部探查。49例探查结果呈阳性。关于长期并发症，记录到2例颅神经丛部分麻痹，以及各1例四肢瘫痪、偏瘫和声门麻痹。据我们所知，首次将头颈部战伤的一期缝合（辅以抗生素治疗）以及用颈深筋膜中层重建广泛的喉气管损伤作为战争外科手术方法。
