COMPREHENSIVE TREATMENT OF GUNSHOT INJURIES OF SOFT TISSUES OF THE LIMBS USING VACUUM THERAPY
DOI:
https://doi.org/10.11603/2414-4533.2025.4.15404Keywords:
combat trauma, negative pressure, wound processAbstract
The aim of the work: to study the feasibility and effectiveness of using VAC therapy in the complex treatment of gunshot and mine-explosive soft tissues injuries of the limbs.
Materials and Methods. A retrospective analysis of the treatment of 172 patients with wound defects after gunshot/mine-explosive soft tissues injuries during 2022–2025 was conducted. The wound process was monitored using clinical, cytological, microbiological and morphological criteria according to standard methods. The microhemodynamics of the lower extremities were studied by laser Doppler fluorometry. Material for morphological research was obtained by excisional biopsy. GENADYNE XLR8 Plus device (USA) was used for VAC wound therapy. Numerical results were statistically processed using computer programs S-PLUS 2000, STATISTICA, Excell.
Results. When using VAC therapy, active formation of granulation tissue began after (4.64±1.27) days, and by (9.36±1.13) days, wound defects were ready for plastic closure. Along with this, a significant reduction in the volume of wound defects was also noted (p<0.05). The use of VAC therapy until the 6th-9th day allowed to reduce the total density of microorganisms below the critical level, to (4.12±0.45) lg CFU/g. Starting from the 3rd day of VAC therapy, there was a significant improvement in local wound microcirculation. The obtained results made it possible to carry out plastic stages of wound closure 1.5–2 times faster than without using the above-mentioned method. The average term of treatment of the wounded in hospital was (33.7±4.6) bed-days. 157 (91.3 %) of the wounded were discharged for further treatment in ambulatory conditions and rehabilitation. 15 (8.7 %) of the wounded were transferred to the medical institutions of the level IV.
Conclusions. Vacuum wound therapy is an effective method of local treatment of gunshot wounds of soft tissues, which provides a beneficial effect on the course of all stages of the wound process, and allows to almost halve the time it takes to prepare gunshot wounds for their closure. Therefore, it allows to reduce the duration of treatment of the wounded in hospital by an average of (14.5±3.1) bed-days, which has not only medical but also social significance.
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