Abstract

Introduction: Cerebrospinal fluid leak is a common complication after head gunshot wounds, which commonly leads to infectious complications. This complication may prolong hospital staying and prevents soldiers from return to operation theatre as soon as possible. 
 The purpose of this article is to determine the impact of the quality of primary surgical debridement and other factors that influenced the presence of cerebrospinal fluid leak in the military stuff with gunshot wounds to the head. 
 Materials and methods: This is a retrospective study of 20 military cases with cerebrospinal fluid leak, which were admitted during the combat actions in Eastern Ukraine in the period from March 2014 to the end of December 2017. Information was collected on demographics, evacuation assistance, type of injury and infectious complications. R commander version 4.2.0 (http://www.r-project.org) was used for statistical analysis. Statistical significance was defined as p<0.05.
 Results: Cerebrospinal fluid fistulas were detected in 20 cases (25,31%). Factors affecting the rate of leaks are number of re-operations (p<0.001), multiple sites of injury (p=0.002), ventricular injury (p<0.005). CSF leakage significantly lengthens hospitalization time.
 Conclusions: CSF fistula influenced significantly rate of infection complication. Reoperation should follow initial surgery in cases of CSF leak development. To avoid development of cerebrospinal fluid fistulas, the operation should be performed by neurosurgeons in specialized department.

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