Treatment of victims with mine-explosive injuries

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OBJECTIVE

To study the incidence and structure of combat gunshot surgical trauma received during the 2^nd Karabakh War and to analyze the results of treatment of these victims.

MATERIAL AND METHODS

We analyzed surgical treatment of 60 victims with combat gunshot surgical trauma received during the 2^nd Karabakh war. In 25 (41.7%) victims, injury occurred as a result of mine-explosive trauma. These victims were divided into 3 groups depending on mechanism of mine-explosive injury. The 1^st group included 7 (28%) patients who received mine-explosive injury due to indirect (propelling) effect of blast wave. The 2^nd group included 14 (56%) victims in whom mine-explosive injury was caused by non-contact (distant) impact of mine fragments. The 3^rd group consisted of 4 (16%) patients whose mine-explosive injuries were caused by direct impact of explosion factors on various anatomical areas. Patients were also ranked into 3 groups depending on the nature and severity of mine-explosive injury: wounded with isolated injuries (n=16, 64%), wounded with concomitant injuries (n=2.8%), wounded with combined and multiple injuries (n=7, 28%).

RESULTS

Most patients underwent organ-sparing procedures. Resections were performed only in 4 cases (splenectomy — 3, nephrectomy — 1). Postoperative complications developed in 23 (38.3%) wounded (suppuration of postoperative wounds — 13, post-traumatic pleuritis — 5, clotted hemothorax — 2, subphrenic abscess — 1, phlegmon of perineum and perianal region — 2). Mortality rate was 1.7%.

CONCLUSION

Timely sorting and evacuation of victims, early qualified surgical care and correct postoperative management with monitoring of vital functions can improve the results of treatment of victims with mine-explosive trauma. Autologous skin grafting for extensive defects and closure of colostomy with restoration of colon continuity were essential in rehabilitation of these patients.

Keywords:

combat gunshot injury

mine-explosive injury

combined and multiple injuries

treatment

Authors:

Aliev S.A.

Azerbaijan Medical University

Bayramov N.Yu.

Azerbaijan Medical University

Received:

04.04.2022

Accepted:

10.05.2022

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