Complication Of Gunshot Wounds Research Articles

Вакуум-активна терапія у комплексному лікуванні постраждалих із вогнепальними пораненнями

VAC-therapy — сучасна новітня методика лікування ран, що значно поліпшує перебіг усіх стадій ранового процесу: зменшує локальний набряк, сприяє посиленню місцевого кровообігу, знижує рівень мікробного обсіменіння, призводить до відносно швидкого зменшення ранової порожнини, скорочуючи термін загоєння. Ціллю нашого дослідження було визначити клінічну ефективність використання VAC-therapy у лікуванні постраждалих із вогнепальними пораненнями. Для виконання нашого дослідження ми проаналізували лікування 74 постраждалих із вогнепальними пораненнями, що були отримані в результаті бойових дій, які лікувались у Військово-медичному клінічному центрі Центрального регіону в період 2015–2016 років. Проведене дослідження показало, що використання VAC-therapy є можливим у постраждалих із місцевими інфекційними ускладненнями вогнепальних поранень, значно покращує результати лікування ранового процесу у постраждалих із вогнепальними пораненнями, ускладненими гнійною інфекцією, що дозволяє рекомендувати VAC-therapy у клінічне використання.

SURGICAL TACTICS FOR PURULENT-SEPTIC COMPLICATIONS OF COMBAT BELLY INJURIES

Summary. Combat injury of the abdomen, according to the ATO / OOS is from 6.7 to 9 %. The specificity of gunshot wounds to the abdomen causes the development of functional disorders and complications (51–81 %) and, as a consequence, a high mortality rate (12–31 %).
 Objective: To improve the effectiveness of surgical treatment of purulent-septic complications in the wounded with combat trauma to the abdomen (BTC).
 Materials and methods. The Military Medical Clinical Center of the Southern Region (VMKC PR) analyzed the treatment of 86 wounded who were hospitalized with purulent-septic complications of BTZ from 2014 to 2020, taking into account the location, clinical manifestations and severity of injury, used modern treatment methods , namely: puncture and drainage interventions under the control of ultrasonography and installation of NPWT systems. Comprehensive treatment was supplemented with antibacterial therapy and oxygen barotherapy.
 First of all, the wounded underwent puncture and drainage interventions under ultrasonic navigation and gradual rehabilitation for diagnostic and therapeutic purposes. NPWT therapy was used in 11 patients with extensive wounds and purulent-septic complications of the soft tissues of the anterior abdominal wall.
 Thus, the use of interventional sonography, as the primary diagnostic and treatment method for the treatment of purulent-inflammatory complications of combat trauma to the abdomen, has improved the quality of diagnosis and reduced traumatic interventions, which has reduced postoperative complications and inpatient treatment.
 Results and discussion. Eleven (14.2 %) cases of puncture and drainage interventions were ineffective, in connection with which we had to resort to traditional methods of treatment — opening and drainage of purulent-inflammatory foci and the use of NPWT-therapy. Vacuum therapy is an effective method of treatment of purulent-septic complications of gunshot wounds of the soft tissues of the abdomen, which in combination with puncture-drainage interventions, can reduce by 2.5 times the number of repeated operations (mainly multi-stage surgical treatments), thereby reducing 1.8 times the length of stay of patients in the hospital.
 Conclusions. Thanks to the use of modern methods it was possible to improve the results of surgical treatment of purulent-septic complications in the wounded with purulent-septic complications of combat trauma to the abdomen.
 The use of the latest techniques has helped reduce the number of invasive treatments, accelerate recovery, reduce bed rest, reduce intoxication, and increase the rate of return of servicemen.

Acute and Long-Term Complications of Gunshot Wounds to the Head

Traumatic brain injury (TBI) secondary to gunshot wounds is a common problem in the USA and presents with a unique set of acute and chronic complications. Recent publications in trauma and critical care literature have sought to better understand incidence, demographics, and acute complications of gunshot wounds to the head. These findings, coupled with literature on rehabilitation of TBI patients secondary to gun violence, may help brain injury physiatrists better understand issues which may arise during rehabilitation. Clinical commonalities among TBI patients with gunshot wounds to the head provide a foundation for suggested management paradigms. Patients with gunshot wounds to the head represent a unique subset of the TBI population associated with the pathophysiology of a penetrating brain injury, including intracranial infection, early seizures, and CSF leak. Mood and substance use disorders may further complicate rehabilitation and require attention to maximize patients’ benefit from rehabilitation.

Surgical care to the wounded with large bowel battle truma during the anti-terrorist operation

A study of surgical treatment at the stages of medical evacuation of 83 wounded with a battle trauma to the abdomen and damage to the large bowel, received during the anti-terrorist operation. The wounded patients were divided into two groups: the comparison group — 42 patients with a traditional surgical management, and the main group — 41 patients with a priority surgical management, which depended on the severity of the condition, the severity of internal injuries and operational and tactical circumstances. At the second level of medical care, the surgical management and the extent of surgical interventions were determined: full, abbreviated or damage control surgery. At the III–IV levels of medical care, planned repeated operations “damage control surgery”, “second look”, as well as comprehensive treatment of the consequences and complications of gunshot wounds were performed.A new approach to the choice of surgical management, as well as the standardization of the estent of surgical interventions have reduced the number of postoperative abdominal complications by 27% and mortality rate — by 16.4%.

Components of the effectiveness of practical training in clinical microbiology of the doctors-interns of surgical profile

Annotation. Practical training is the main type of training for interns, during which practical skills are formed and clinical thinking of future surgical specialists is improved. The purpose is to determine the components of the effectiveness of practical training in clinical microbiology for physicians-interns of surgical profile. In the teaching of clinical microbiology in practice, it is important to clearly differentiate the thematic focus, considering the future specialty of the intern. Interns for surgeons and traumatologists need to know the biological characteristics of aerobic and anaerobic microorganisms involved in the complication of gunshot wounds. It is advisable to dedicate one of the practical lessons to the future aspects of laboratory diagnostics and the use of biological products in the treatment of vaginosis for future obstetricians-gynecologists. For ophthalmologists, it is extremely important to have a practical training session on microorganisms that infect the cornea, causing viral, bacterial, fungal, protozoal keratitis; We emphasize the risks of contact lens-related infections. Surgical profile interns at clinical microbiology classes study and practically work out methods of microbiological examination of pathological material isolated from patients, master the skills of interpretation of the obtained results, and decide on etiotropic treatment of the patient. A necessary component of training interns of a surgical profile in clinical microbiology is the implementation of multicontrol of the level of knowledge, knowledge of modern aspects of diagnostics and interpretation of the obtained results. Based on the criteria obtained, the intern can make the right decision and interpret any clinical situation.

Vascular Complications of Gunshot Wounds to the Head

Vascular Complications of Gunshot Wounds to the Head

Septicæmia as a complication of gunshot wounds, with notes on 13 cases

Journal Article Septicæmia as a complication of gunshot wounds, with notes on 13 cases Get access H M Anderson, R.A.M.C., H M Anderson, R.A.M.C. Search for other works by this author on: Oxford Academic Google Scholar G Richardson, R.A.M.C. G Richardson, R.A.M.C. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 5, Issue 19, January 1917, Pages 393–416, https://doi.org/10.1002/bjs.1800051905 Published: 02 March 2006

A study of the symptoms and complications of gunshot wounds of the solid abdominal viscera

A study of the symptoms and complications of gunshot wounds of the solid abdominal viscera

Reflex sympathetic dystrophy.

Reflex sympathetic dystrophy indicates the syndrome of a painful, swollen, discoloured, abnormally sensitive, and useless extremity, usually developing after trauma, and first described as a complication of gunshot wounds in the American Civil War.1 Even after 130 years, we still cannot agree what to call it, do not understand what causes it, and do not know how best to treat it. The term reflex sympathetic dystrophy, or the reflex sympathetic dystrophy syndrome, seems to be preferred by those writing in English, algodystrophy by those writing in French, and Sudeck's atrophy by those writing in German or referring to a late atrophic phase of the condition. Definitions and clinical criteria abound.2 The International Association for the Study of Pain produced the following definition: “continuous pain in a portion of an extremity after trauma which may include fracture but does not involve a major nerve, associated with sympathetic hyperactivity.”3 Kozin, whose criteria for diagnosis are most widely quoted, considered it essential to recognise that pain may be the only manifestation of the reflex sympathetic dystrophy syndrome and also included patients with vasomotor or sudomotor changes without pain or tenderness as possibly having the syndrome.4 The consensus report of an ad hoc committee of the American Association for Hand Surgery considered that the term reflex sympathetic dystrophy was used too loosely to be valuable and errors of under and over diagnosis occurred.5 It agreed on the following definition: a pain syndrome in which the pain is accompanied by loss of function and evidence of autonomic dysfunction (figs 1-3). FIG 1 Reflex sympathetic dystrophy of the right hand after a fall, with no bony injury. The affected hand is discoloured and the fingers are swollen FIG 2 Reflex sympathetic dystrophy of the right foot occurring spontaneously in pregnancy. The patient responded to guanethidine …