OPTIMAL APPROACHES FOR LOCAL TREATMENT OF GUNSHOT WOUNDS TO FACILITATE EARLY WOUND HEALING

Abstract

Gunshot wounds comprise a significant category of injuries resulting from firearm use, involving not only the impact of the blast wave but also damage from metal and secondary tissue fragments. This topic remains highly relevant today, as the appropriateness of local and surgical treatments plays a crucial role in the prompt regeneration of damaged tissues, prevention of purulent complications, swift closure of wound defects, and the optimal restoration of organ function, thereby reducing disability rates for patients.
 This study aims to compare and determine the clinical effectiveness of traditional dressings with antiseptic (Study Group I), hydroactive superabsorbent dressings (Group II), and Vacuum-Assisted Closure (VAC-therapy) (Group III) to provide cleansing of gunshot wounds, prepare the wound surface for skin plastic surgery, prevent secondary necrosis, purulent complications, and ensure the rapid rehabilitation of patients.
 The study included 154 wounded individuals, divided into three groups, with an age range spanning 18 to 50 years. Following our study, it can be inferred that the use of Vacuum-Assisted Closure (VAC-therapy) proves most effective in treating gunshot wounds. This method stimulates the early growth of granulation tissue, with mature granulation tissue evident as early as the 4th day, in contrast to the use of hydroactive dressings (on the 6th day) and traditional gauze material with an antiseptic (on the 7th day). VAC-therapy facilitates marginal epithelization and wound contraction, preventing the development of secondary necrosis and severe purulent complications. Moreover, this approach requires shorter-term antibiotic therapy, exhibits the lowest rate of complications post-repair of a wound defect, and reduces the rehabilitation period for the wounded.