Temporary arterial shunts in combat patient with vascular injuries to extremities wounded in Russian-Ukrainian war: A case report.

Autor:	Rogovskyi VM; Department of Vascular Surgery, National Military Medical Clinical Center of Ministry of Defense of Ukraine, Kyiv, Ukraine., Koval B; Department of Vascular Surgery, National Military Medical Clinical Center of Ministry of Defense of Ukraine, Kyiv, Ukraine; Department of Surgery, Bogomolets National Medical University, Kyiv, Ukraine., Lurin IA; National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine; State Scientific Institution 'Research and Practical Center of Preventive and Clinical Medicine', State Administration of Affairs, Kyiv, Ukraine., Gumeniuk K; Medical Forces Command, Armed Forces of Ukraine, Kyiv, Ukraine; Department of Military Surgery, Ukrainian Military Medical Academy, Kyiv, Ukraine., Gorobeiko M; Department of Surgery, Institute of Biology and Medicine, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine., Dinets A; Department of Surgery, Institute of Biology and Medicine, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine. Electronic address: andrii.dinets@knu.ua.
Jazyk:	angličtina
Zdroj:	International journal of surgery case reports [Int J Surg Case Rep] 2023 Jan; Vol. 102, pp. 107839. Date of Electronic Publication: 2022 Dec 19.
DOI:	10.1016/j.ijscr.2022.107839
Abstrakt:	Introduction and Importance: Vascular injuries to extremities are common in armed conflicts. Such kind of injury is associated with a high risk of critical ischemia, limb amputation, and high morbidity. There is a clinical challenge for the management of vascular injuries to extremities in ongoing warfare due to limited medical resources. Presentation of Case: A 34 years old male received a gunshot injury to both low extremities on March, 23rd 2022 in a battlefield area 30 km away from Kyiv city. CAT tourniquet was applied to stop the bleeding and the patient was transported to Level II by ambulance 40 min after the injury. The patient was diagnosed with a gunshot injury to the left superficial femoral artery (SFA) followed by primary surgical debridement and temporary arterial shunting at Level II hospital. Then the patient was evacuated to Level IV hospital, diagnosed with an injury to the right popliteal artery, and underwent vascular reconstruction. Clinical Discussion: Arterial shunting is a well-known approach to prevent critical ischemia and limb amputations of injured extremities in both combat and civilian patients. This case report provides evidence for the utility of temporary arterial shunting in combat conditions, which is supported by data from the larger cohorts. We consider temporary vascular shunting as a damage control measure to be associated with high chances of limb salvage in ongoing warfare. Conclusion: Our study demonstrated the utility of temporary arterial shunting in combat patients with gunshot wounds in ongoing warfare, which could be performed even in case of limited medical resources. Competing Interests: Declaration of competing interest N/A. (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
Databáze:	MEDLINE
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