| Abstrakt: |
Background. The full-scale war with the russian federation on the territory of Ukraine revealed a number of problematic issues regarding medical and evacuation measures for victims with gunshot injuries to the extremities, requiring the search for ways to solve them and substantiate proposals for optimizing the adjusted system of treating victims. Over a 3-month period, the number of patients with gunshot wounds to the limbs and the severity of injuries increased significantly, which is primarily due to the use of weapons with high kinetic energy (Grad, Smerch MLRS systems, air bombs, including cluster munitions, artillery and tanks (large caliber)), which led to an increase in the number of patients with severe gunshot injuries. Given these features, the question arose not only regarding the training of specialists in the treatment of modern combat injuries, but also optimizing the therapeutic process, which made this topic relevant. The aim: to analyze the system of surgical treatment for victims with gunshot wounds to the extremities by optimizing the algorithm of surgical treatment at the levels of medical evacuation. Materials and methods. Statistical materials for the period from February 24 to May 2022 and ATO/JFO data for 2014–2021. Research methods: descriptive, comparative analysis, systematic approach, statistical. Based on study results, a number of debatable issues on organizing a system for the treatment of victims with gunshot wounds were identified: analysis of the distribution of patients by a type of damaging factor; optimization of triage of victims with gunshot wounds to the extremities; general characteristics of the basic principles of treatment at the hospital stage; the presence of errors in the treatment of victims with long-bone gunshot fractures. Conclusions. The widespread use of weapons with high kinetic energy during the full-scale war with the russian federation in Ukraine determined an increase in the proportion of limb lesions and the severity of these injuries. At the same time, there was an increase in the number of victims with amputated limbs, defects in long bones and polystructural trauma. Rational medical triage in the mass admission of patients with limb injuries, which we carried out, made it possible to create conditions for the full implementation of medical and diagnostic measures with the subsequent determination of priority areas. [ABSTRACT FROM AUTHOR] |
