Abstract
Background. One of the characteristics of a combat injury is the penetration of pathogenic microorganisms, pieces of dirty skin, clothes, dust, etc. into the depth of the wound. The combination of significant defects of bones and soft tissues, vessels and nerves of the affected segment of the limb (musculoskeletal system) causes a high percentage of unsatisfactory treatment results, as well as the development of infectious complications.
Objective: to evaluate the nature of combat wounds in patients who had infectious complications in the musculoskeletal system during the war in Ukraine since 2014; to determine the features of the occurrence and development of such infectious complications.
Materials and Methods. An analysis of case reports of patients with combat wounds with infectious complications (osteomyelitis, septic arthritis, surgical site infection (SSI), purulent- necrotic infection of soft tissues and wounds) who were treated at the Department of Bone- Purulent Surgery of the State Institution “Institute of Traumatology and Orthopedics of the National Academy of Medical Sciences of Ukraine” for the period from 2014 to mid-2022 was carried out.
Results and Conclusions. Infectious complications in combat wounds mostly arise primarily as a result of the wound itself, taking into account the severity, extent of damage to structures and tissues, the type of weapon used to inflict the injury, and a wide spectrum of microorganisms, among which Staphylococcus aureus plays a leading role. In the control group, infectious complications occurred more often than SSI with further progression.
References
Roshchin HH, Mazurenko OV, Humeniuk KV, Kuzmin VIu, Slychko IY, Ivanov VI, ta in. Unified protocols for providing emergency medical aid as an element of civil-military interaction in the territories of special operations in Ukraine. TRAVMA. 2021;21(2):66-79. DOI: 10.22141/1608-1706.2.21.2020.202236.
[in Ukrainian].
Borzykh NO. Surgical treatment of the wounded with polystructural gunshot injuries of the upper limb and their consequences [Dysertatsiia na zdobuttia naukovoho stupenia doktora medychnykh nauk]. Kyiv; DU “Instytut travmatolohii ta ortopedii NAMN Ukrainy”; 2018. [in Ukrainian].
Strafun SS, Laksha AM, Shypunov VH, Borzykh NO, Lozhkin IO. Errors and complications of diagnosis and treatment of local hypertensive ischemic syndrome with gunshot injuries of the lower extremities. TRAVMA. 2021;20(4):105-112. DOI: 10.22141/1608-1706.4.20.2019.178754. [in Ukrainian].
Haiko HV, Strafun SS, Kurinnyi IM. Errors and complications in the treatment of gunshot wounds of the extremities. Visnyk ortopedii, travmatolohii ta protezuvannia. 2018;(2): 4-8. [in Ukrainian].
Loskutov AYe, Belyy SI, Daragan RI. Features of the treatment of gunshot wounds of the hand in modern conditions. Ortopediya, travmatologiya i protezirovanie. 2018;(2):57-62. DOI: 10.15674/0030-59872018257-62. [in Russian].
Burianov OA, Hrytsai MP, Omelchenko TM, Yarmoliuk YuO. The choice of antibacterial therapy in patients with open and gunshot injuries of the limbs and their complications. Litopys travmatolohii ta ortopedii. 2017;1-2(35-36):113-118. [in Ukrainian].
Savchenko SV. Mechanisms and causes of the death of servicemen as a result of hostilities in the ATO zone according to the results of the analysis of forensic medical examination protocols; Medychne zabezpechennia antyterorystychnoi operatsii: naukovo-orhanizatsiini ta medyko-sotsialni aspekty: zbirnyk naukovykh prats. Za zah. red. akademikiv NAN Ukrainy Tsymbaliuka VI ta Serdiuka AM. K.: DP “NVTs “Priorytety”, 2016. 316 s. [in Ukrainian].
Usenko OIu, Saliutin RV, Halych SP, Lavryk AS, Mazur AP. A multidisciplinary approach to the treatment of mine and explosive injuries in the conditions of a highly specialized surgical clinic; Medychne zabezpechennia antyterorystychnoi operatsii: naukovo-orhanizatsiini ta medyko-sotsialni aspekty: zbirnyk naukovykh prats. Za zah. red. akademikiv NAN Ukrainy Tsymbaliuka VI ta Serdiuka AM. K.: DP “NVTs “Priorytety”, 2016. 316 s. [in Ukrainian].
Danchyn OH, Polishchuk MIe, Danchyn HO. Features of the organization of neurosurgical care for gunshot wounds of the soft tissues of the cranial vault in large-scale wars and local military conflicts; Medychne zabezpechennia antyterorystychnoi operatsii: naukovo-orhanizatsiini ta medyko-sotsialni aspekty: zbirnyk naukovykh prats. Za zah. red. akademikiv NAN Ukrainy Tsymbaliuka VI ta Serdiuka AM. K.: DP “NVTs “Priorytety”, 2016. 316 s. [in Ukrainian].
Herasymenko OS. Clinical and organizational principles of providing surgical care and specialized treatment of the wounded with abdominal combat trauma in ATO conditions: [avtoref. dys na zdobuttia nauk. stup. d-ra med. nauk]. Kyiv: DU “Nats. in-t khirurhii ta transplantolohi im. O. O. Shalimova”; 2021. 51 s. [in Ukrainian].
Herzhyk KP. Videothoracoscopic surgery for combat wounds and chest injuries: [avtoref. dys. na zdobuttia nauk. stup. kand. med. nauk]. Kyiv. Nats. med. akad. pisliadyplom. osvity im. P. L. Shupyka; 2020. 27 s. [in Ukrainian].
Klapchuk YuV. Sanitary losses of servicemen with gunshot wounds of large joints. TRAVMA. 2021;22(1):47-51. DOI: 10.22141/1608-1706.1.22.2021.226413. [in Ukrainian].
Borzykh NO, Strafun OS, Vlasenko MO. Surgical treatment of the wounded with penetrating gunshot injuries of the elbow joint. Ortopedyia, travmatolohyia y protezyrovanye. 2018;(1):29-33. DOI: 10.15674/0030-59872018129-33. [in Ukrainian].
Loskutov OIe, Domanskyi AM, Zherdiev II, Lushnia SL. Peculiarities of providing medical assistance to patients with gunshot wounds of the elbow joint. Ortopedyia, travmatolohyia y protezyrovanye. 2021;(1):5–8. DOI: 10.15674/0030- 5987202115-8. [in Ukrainian].
Strafun SS, Borzykh NO, Haiko OH, Borzykh OV, Haiovych VV, Tsymbaliuk YaV. Priority areas of surgical treatment of the wounded with damage to the peripheral nerves of the upper extremity in case of polystructural injuries. TRAVMA. 2021;19(3):75–80. DOI: 10.22141/1608-1706.3.19.2018.136410. [in Ukrainian].
Martsynkovskyi IP. Scientific substantiation of the volume and nature of surgical assistance to servicemen as a result of modern hostilities at the stages of medical assistance [Dysertatsiia na zdobuttia naukovoho stupenia kandydata medychnykh nauk]. Vinnytsia; DZ “Ukrainskyi naukovo-praktychnyi tsentr ekstrenoi medychnoi dopomohy ta medytsyny katastrof MOZ Ukrainy”, Vinnyts. nats. med. un-t im. MI Pyrohova; 2020. 198 s. [in Ukrainian].
Korol S. Bone grafting in the system of specialized treatment of the wounded with combat injuries of the extremities. TRAVMA, 2021;19(1):20-26. DOI: 10.22141/1608-1706.1.19.2018.126659. [in Ukrainian].
Strafun SS, Burianov OA, Borzykh OV, Dolhopolov OV, Lysak AS, Shypunov VH, Yarmoliuk YuO, ukladachi. Compartment syndrome in gunshot wounds of the extremities: methodical recommendations. DU “Instytut travmatolohii ta ortopedii NAMN Ukrainy”, Natsionalnyi medychnyi universytet imeni O.O. Bohomoltsia MOZ Ukrainy, Ukrainska viiskovo-medychna akademiia MO Ukrainy, Holovnyi viiskovo-medychnyi klinichnyi tsentr “Holovnyi viiskovyi klinichnyi hospital” MO Ukrainy, rozrobnyky. Visnyk ortopedii, travmatolohii ta protezuvannia. 2022;(1):72-85. [in Ukrainian].
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