An experience of staged treatment of gunshot wounds

The article describes clinical cases of successful treatment of gunshot wounds (shot) in the Trauma Department of the Scientific Research Institute – Regional Clinical Hospital No. 1 named after Professor S.V. Ochapovsky" (Krasnodar, Russia). In the treatment of gunshot fractures, the recognized method is the use of external transosseous fixation devices, but in modern conditions it is possible to use various surgical techniques of one-stage and staged treatment. To prevent infectious complications, in addition to medications, VAC drainage and subsequently delayed autodermoplasty are recommended for victims with the most severe fractures.

Purpose of a study: to select the most successful effective tactics for the treatment of non-standard clinical cases with ligamentous gunshot wounds of the extremities.

Material and methods. Upon admission, all wounded underwent laboratory tests: general blood and urine tests, biochemical blood tests, immunological cytological studies, radiography and ultrasound examination (ultrasound) of the injured limb. Subsequently, surgical treatment of the wound, its vacuum therapy, plastic surgery with pedicle flaps and free skin autoplasty were performed in stages.

Results. To replace the wound defect with exposure of deep anatomical structures, plastic surgery with skin-fat flaps was performed with an individual approach to the choice of the type of skin plastic surgery.

Conclusion. The key factors for the success of the surgical results are consistency in treatment and active monitoring of the wound surface, aimed at early detection of potential complications in the postoperative period.

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