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Nikolaev K.N.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia

Ivchenko D.R.

Department of Medical Support of the National Guard, Moscow, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Fedorchenko V.E.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Emelyanov I.N.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Putintsev S.P.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Combined gunshot penetrating chest wounds: current state of the problem (scoping review)

Authors:

Nikolaev K.N., Ivchenko D.R., Fedorchenko V.E., Emelyanov I.N., Putintsev S.P.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2026;(3): 78‑94

DOI: 10.17116/hirurgia202603178

Read: 642 times

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Table of contents

COMBINED GUNSHOT PENETRATING CHEST WOUNDS: CURRENT STATE OF THE PROBLEM (SCOPING REVIEW)
COMBINED GUNSHOT PENETRATING CHEST WOUNDS: CURRENT STATE OF THE PROBLEM (SCOPING REVIEW)

To cite this article:

Nikolaev KN, Ivchenko DR, Fedorchenko VE, Emelyanov IN, Putintsev SP. Combined gunshot penetrating chest wounds: current state of the problem (scoping review). Pirogov Russian Journal of Surgery. 2026;(3):78‑94. (In Russ.)
https://doi.org/10.17116/hirurgia202603178

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

BACKGROUND

Combined gunshot chest wounds are one of the most severe injuries, are associated with a high mortality, a high number of various complications, and require long-term treatment.

OBJECTIVE

To study and summarize the treatment outcomes in patients with combined gunshot penetrating chest wounds in world practice during armed conflicts and in peacetime.

MATERIALS AND METHODS

A literature search was conducted in the medical Internet search system PubMed and the e-library search system for the keywords “combat thoracic trauma,” “combined gunshot chest wounds,” “thoracoabdominal wounds,” and “gunshot chest wounds” for the period from 1980 to 2025; also, Russian studies on the treatment of combined gunshot chest wounds were reviewed. The review included scientific papers addressing the epidemiology, evacuation, diagnosis, treatment, prevention, and expert evaluation of combined gunshot penetrating chest wounds.

RESULTS

The initial search identified 3.718 papers, of which 35 were eventually selected. Combined gunshot penetrating chest wounds account for 81.9% of all chest injuries; the mortality varies from 3 to 80%. Thoracoabdominal wounds receive much more attention compared to wounds of other sites due to their high prevalence (10—35%), severity, and mortality up to 59%. A high prevalence of explosive wounds in the armed conflicts of the 21st century and the use of cluster munitions with an atypical trajectory of projectiles result in high relevance and social significance of not only thoracoabdominal wounds, but also combined wounds to the chest and limbs unprotected by armor plates, leading to the disability of military personnel.

CONCLUSION

The high mortality indicates the need to improve treatment and diagnostic approaches, develop new therapies for combined injuries of the chest, abdomen, and limbs, and find effective ways to evacuate the injured from the battlefield for medical care.

Keywords:

battle chest injury
combined gunshot chest wounds
thoracoabdominal wounds
gunshot chest wounds
victim
thoracoscopy

Authors:

Nikolaev K.N.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia

Ivchenko D.R.

Department of Medical Support of the National Guard, Moscow, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Fedorchenko V.E.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Emelyanov I.N.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Putintsev S.P.

Main Military Clinical Hospital Russian National Guard Troops, Balashikha, Russia;
Russian Medical Academy of Continuing Professional Education, Moscow, Russia

Received:

27.08.2025

Accepted:

06.11.2025

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