Peculiarities of surgical care in case of open injuries of limbs in emergency situations in peacetime

Dubrov V.; Mitish V.A.; Kobritsov G.P.; Shabanov V.; Baĭramov Sh.A.; Khanin M.Iu.

doi:https://doi.org/

Dubrov V.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova

Mitish V.A.

Institut khirurgii im. A.V. Vishnevskogo MZ RF;
ndokrinologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii;
Kafedra meditsiny katastrof Rossiĭskogo universiteta druzhby narodov, Moskva

Kobritsov G.P.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova

Shabanov V.

Vserossiĭskiĭ tsentr meditsiny katastrof "Zashchita" Minzdrava RF

Baĭramov Sh.A.

Nauchno-issledovatel'skiĭ institut skoroĭ pomoshchi im. N.V. Sklifosovskogo , Moskva

Khanin M.Iu.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova

Peculiarities of surgical care in case of open injuries of limbs in emergency situations in peacetime

Authors:

Dubrov V., Mitish V.A., Kobritsov G.P., Shabanov V., Baĭramov Sh.A., Khanin M.Iu.

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Journal: Pirogov Russian Journal of Surgery. 2014;(5): 60‑66

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Dubrov V, Mitish VA, Kobritsov GP, Shabanov V, Baĭramov ShA, Khanin MIu. Peculiarities of surgical care in case of open injuries of limbs in emergency situations in peacetime. Pirogov Russian Journal of Surgery. 2014;(5):60‑66. (In Russ.)

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

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Abstract:

It was done the comparative analysis of treatment results of casualties with open injuries of limbs in emergency situations in peacetime. It was determined that traditional approach of field surgery is unacceptable for this group of casualties. It is connected with limitations of evacuation and high frequency of complications. The developed modified surgical protocol permits not only to provide specialized care to casualties with soft tissue trauma and open fracture of limbs but also to reduce frequency of deep suppuration in 1.9 times. Also it allows to decrease number of dressings for one patient and period of the wound defect preparation to reconstructive plastic surgeries in 2.6 and 1.5 times respectively.

Keywords:

large wounds

open fracture

emergency situation

debridement

Authors:

Dubrov V.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova

Mitish V.A.

Institut khirurgii im. A.V. Vishnevskogo MZ RF;
ndokrinologicheskiĭ nauchnyĭ tsentr Minzdrava Rossii;
Kafedra meditsiny katastrof Rossiĭskogo universiteta druzhby narodov, Moskva

Kobritsov G.P.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova

Shabanov V.

Vserossiĭskiĭ tsentr meditsiny katastrof "Zashchita" Minzdrava RF

Baĭramov Sh.A.

Nauchno-issledovatel'skiĭ institut skoroĭ pomoshchi im. N.V. Sklifosovskogo , Moskva

Khanin M.Iu.

Moskovskiĭ gosudarstvennyĭ universitet im. M.V. Lomonosova

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References:

Botyakov А.А. Mekhanicheskie sposoby v kompleksnom lechenii gnojnykh ran myagkikh tkanej (ehksperimental'no-klinicheskoe issledovanie) [Mechanical methods in treatment purulent wounds of soft tissues (experimental and clinical research)]: Аvtoref. dis. ... kand.med. nauk. Kazan' 2008; 158.(in Russian)
Vladimirov V.А. XXI vek - vyzovy i ugrozy [XXI century - challenges and threats]. M: In-oktavo 2005; 304.(in Russian)
Garkavi А.V. Okazanie meditsinskoj pomoshhi porazhennym pri zemletryasenii v Kolumbii [Medical care in the earthquake in Colombia]. Meditsinskaya pomoshh' 1999; 4: 29-31.(in Russian)
Garkavi А.V., Musalatov KH.А. Аlgoritm dejstvij pri okazanii meditsinskoj pomoshhi porazhennym s povrezhdeniyami dlinnykh trubchatykh kostej konechnostej v usloviyakh chrezvychajnykh situa-tsij [Sequence of actions in health care infected with long lesions tubular bones of the extremities in emergency situations]. Meditsina katastrof 2000; 32: 4: 71-75.(in Russian)
Goncharov S.F., Bobij B.V. Nekotorye problemy meditsinskogo obespecheniya naseleniya v krizisnykh situatsiyakh [Some problems of medical support people in crisis situations]. Voen-med zhurn 2005; 7: 15-22.(in Russian)
Gordienko D.I. Taktika khirurgicheskogo lecheniya otkrytykh perelomov goleni [Surgical treatment of open fractures of the tibia]: Аvtoref. dis. ... kand.med. nauk. M 2013; 172.(in Russian)
ZHunusov E.T. Iskhody lecheniya bol'nykh s otkrytymi perelomami dlinnykh kostej [Treatment outcomes for patients with open fractures of long bones]. Genij ortopedii 2005; 3: 15-19.(in Russian)
Kudryavtsev B.P. Organizatsiya khirurgicheskoj pomoshhi pri povrezhdeniyakh i raneniyakh myagkikh tkanej v chrezvychajnykh situatsiyakh [Organization of surgical care for injuries of soft tissue in emergency situations]. Meditsina katastrof 2003; 2: 50-56.(in Russian)
Mirzoyan А.EH., SHved S.I. Sovremennye predstavleniya o printsipakh organizatsii i ob"eme khirurgicheskoj pomoshhi postradavshim pri massovykh katastrofakh (Obzor literatury) [Modern views on the principles of the organization and scope of surgical care to the victims in case of mass disasters (literature review)]. Genij ortopedii 2001; 2: 61-68.(in Russian)
Musalatov KH.А., Garkavi А.V. Okazanie meditsinskoj pomoshhi porazhennym s povrezhdeniyami oporno-dvigatel'noj sistemy pri chrezvychajnykh situatsiyakh [Medical care in patients with injuries of the musculoskeletal system in emergencies]. M: Meditsina 2001; 145.(in Russian)
Petlakh V.I. Organizatsiya i okazanie khirurgicheskoj pomoshhi v polevom pediatricheskom gospitale (na opyte raboty v CHechenskoj Hespublike) [Organization and surgical care in pediatric field hospital (on the experience in the Chechen Republic)]: Аvtoref. dis. ... d-ra med. nauk.M 2008; 247.(in Russian)
Preobrazhenskij V.N., Rozinov V.M., Nazarova I.А. Аnaliz raboty polevykh gospitalej na Severnom Kavkaze [Analysis of field hospitals work in the North Caucasus]. Meditsina katastrof 2002; 3: 4: 43-50.(in Russian)
Sakhno I.I., Sakhno V.I. Meditsina katastrof (organizatsionnye voprosy) [Emergency Medicine (organizational issues)]. M: GOU VUNMTS MZ RF 2001; 560. (in Russian)
Svetukhin А.M., Аmiraslanov YU.А. Gnojnaya khirurgiya: sovremennoe sostoyanie problemy. 50 lektsij po khirurgii [Contaminated surgery: state of the art. 50 lectures on surgery]. Pod red. V.S.Savel'eva. M: Mediya Medika 2003; 235-242. (in Russian)
Sergeev S.V., EHzmekna S., Zelenkina L.I. i dr. Taktika kompleksnoj profilaktiki i lecheniya gnojno-septicheskikh oslozhnenij v klinicheskoj travmatologii [Tactics of integrated prevention and treatment of septic complications in clinical traumatology]. Vestn travmatol i ortoped 2003; 3: 79-84. (in Russian)
Titov R.S. Kompleksnyj metod lecheniya bol'nykh s otkrytymi metaehpifizarnymi perelomami distal'nogo otdela kostej goleni [Comprehensive treatment of patients with open meta-epiphyseal fractures of the distal part of tibia]: Аvtoref. dis. ... kand.med. nauk. M 2008; 154. (in Russian)
Ukazaniya po voenno-polevoj khirurgii [Notes on military surgery]. MO RF, GVMU MO. M 2000; 418. (in Russian)
Ustyugov А.N. Optimizatsiya immobilizatsionnykh meropriyatij postradavshim s povrezhdeniem oporno-dvigatel'noj sistemy pri chrezvychajnykh situatsiyakh [Optimizing of immobilization events in affected with damage of musculoskeletal system in emergency situations]: Аvtoref. dis. ... kand.med. nauk. Irkutsk 2004; 135. (in Russian)
Fidarov EH.Z. Okazanie neotlozhnoj spetsializirovannoj khirurgicheskoj pomoshhi ranenym i porazhennym v lokal'nykh vojnakh I chrezvychajnykh situatsiyakh mirnogo vremeni [Provision of emergency specialized surgical care to the wounded and infected in local wars and peacetime emergencies]: Аvtoref. dis. ...kand.med. nauk. M 1999; 126. (in Russian)
Khrupkin V.I. Organizatsiya neotlozhnoj spetsializirovannoj khirurgicheskoj pomoshhi naseleniyu v chrezvychajnykh situatsiyakh [Organizationofemergencyspecializedsurgicalcaretothepopulationinemergencysituations]. Meditsina katastrof i jekstremal'naya meditsina: Mater. mezhdunar. konf. M 2000; 162-165. (in Russian)
CHadaev А.P., Zverev А.А., Аlekseev M.S. Sovremennye printsipy lecheniya gnojnykh zabolevanij myagkikh tkanej [Modern principles oftreatment of soft tissues purulentdisease]. 50 lektsij po khirurgii. Pod red. V.S. Savel'eva. M: Mediya Medika 2003; 364-370. (in Russian)
CHeplyaev А.А., SHabanov V.EH., Murin M.B. Uchastie polevogo mnogoprofil'nogo gospitalya Vserossijskogo tsentra meditsiny katastrof "Zashhita" v gumanitarnykh aktsiyakh v Respublike YUzhnaya Osetiya i Respublike Аbkhaziya v 2009-2010 godakh [Participation ofmultidisciplinaryfieldhospitalAll-RussianCentre for Disaster Medicine"Protection"inhumanitarian operationsin the Republic ofSouthOssetiaand Abkhaziain 2009-2010.]. Meditsina katastrof 2010; 4: 4-7.(in Russian)
Alexander D. Death and injury in earthquakes. Disasters 2007; 9: 57-60.
Baechler M.E., Groth A.T., Nesti L.J. et al. Soft tissue management of war wounds to the foot and ankle. Foot Ankle Clin 2010; 15: 1: 113-138.
Crowley D.J., Kanakaris K.N., Giannoudis P.V. Debridement and wound closure of open fractures: the impact of the time factor on infection rates. Injury 2007; 28: 8: 879-889.
Dai Zh., Li Y., Lu M. et al. Clinical profile of musculoskeletal injuries associated with the 2008 Wenchuan earthquake in China. Ulus Travma Acil. Cerrahi Derg 2010; 16: 6: 503-507.
Earthquake hazards program [Electronic resource]. United States Geological Survey [Official website]. URL: http: earthquake.usgs.gov/ (accessed 22.10.11).
Emergency war surgery, 3rd US Revision. Ed. Szul A.C., Washington: US Government printing off 2004; 488.
Fuse A., Yokota H. An analysis of Japan Disaster Medical Assistance Team (J-DMAT) deployments in comparison with those of J-DMAT's counterpart in the United States (US-DMAT). J Nippon Med Sch 2010; 77: 6: 3l8-324.
Hammond C., Clift M. Evidence Review: Vacuum assisted closure therapy. NHS Purchasing and Supplies Agency, Centre for Evidence Based Purchasing. London 2008; 101.
Helminen M., Saarela E., Salmela J. Characterisation of patients treated at the Red Cross field hospital in Kashmir during the first three weeks of operation. Emerg Med J 2006; 23: 654-656.
Mehmet S.S., Raymond U., Norbert L. Management of crush-related injuries after disasters. N Engl J Med 2006; 354: 1052-1063.
Moran S.L., Cooney W.P. Master Techniques in Orthopaedic Surgery: Soft Tissue Surgery, 1st Edition. Lippincott Williams & Wilkins 2009; 944.
Murray C.K., Hsu J.R., Solomkin L.S. et al. Prevention and management of infections associated with combat-related extremity injuries. J Trauma 2008; 64: 239-251.
Ramirez M., Peek-Asa C. Epidemiology of traumatic injuries from earthquakes. Epidemiol Rey 2005; 27: 47-55.
Tahmasebi M.N., Kiani K., Mazlouman S.L. et al. Musculoskeletal injuries associated with earthquake. A report of injuries of Iran's December 26. 2003 Bam earthquake casualties managed in tertiary referral centers. Injury 2005; 36: 1: 27-32.
Wang S.Y., Li Y.H., Chi G.B. et al. lnjury-related fatalities in China: an underrecognised public-health problem. Lancet 2008; 372: 1765-1773.
Weitz-Marshall A.D., Bosse M.J. Timing of closure of open fractures. J Am Acad Orthop Surg 2002; 10: 6: 379-384.
World Health Statistics 2008 Report [Electronic resource]. Geneva: World Health Organization [Official website]. URL: http://www.who.int/whosis/whostat/2008/en/ (accessed 16.11.11).