VAC THERAPY IN COMPLEX SURGICAL TREATMENT AND REHABILITATION OF COMBATANTS WITH GUNSHOT WOUNDS OF VARIOUS GENESIS AND LOCALIZATION
DOI:
https://doi.org/10.11603/1811-2471.2024.v.i3.14896Keywords:
military staff, vacuum therapy, gunshot wounds, infection, physical rehabilitationAbstract
SUMMARY. The aim – to analyze and study the problems of treating infected wounds, deep and extensive wound defects, especially after gunshot injuries, mine-explosive injuries, the role of VAC therapy in this process, the importance of physical rehabilitation in restoring the health of combatants in Ukraine with gunshot wounds of various genesis and localization
Material and Methods. The work uses the bibliosemantic method and methods of content- and structural-logical analysis.
Results. Conducting medical (surgical) and rehabilitation measures for military staff with gunshot wounds of various genesis and localization has its own characteristics. Injuries are accompanied by the formation of many fragments of various sizes that affect any part of the human body. Metal foreign bodies at high speed penetrate deep into soft tissues – muscles, fatty tissue, parenchymal organs and the skeleton. On their way, they tear nerve plexuses and blood vessels, break bones, damage the spinal cord and brain. Limb injuries are characterized by frequent amputations and damage to main vessels and large nerve branches. As a result, damage to the innervation manifests itself in paresthesias or has clinical signs of neuritis. All this leads to a huge physical and psychological load, a powerful combined morphological and psychogenic stress is generated. After providing primary medical care and highly specialized surgical treatment (including VAC therapy) in military hospitals, combatants need physical recovery and psychological rehabilitation. This is a very important task, since a military man who received a gunshot wound and mental trauma as a result of combat operations and did not receive adequate rehabilitation measures is not able to effectively conduct combat operations on the battlefield in the future or full return to peaceful life.
Conclusions. 1. The use of VAC therapy is possible in military staff with local infectious complications of gunshot wounds.
- The use of vacuum therapy promotes early cleansing of wounds from layers of fibrin and areas of necrosis, reduction of the area and depth of wounds, growth of granulation tissue, acceleration of marginal epithelization.
- Positive clinical effects on the 3rd–5th day of using VAC therapy contributed to a significant increase in the intensity of cell proliferation, a decrease in the number of neutrophil granulocytes and lymphocytes, and an increase in the relative content of fibroblasts in the wound.
- The use of VAC therapy significantly improves the results of treatment of the wound process in victims with gunshot wounds complicated by purulent infection.
- When using VAC therapy, the second phase of the wound process occurs on the 4th to 6th day, which is twice as fast compared to complex therapy without its use and allows recommending the introduction of VAC therapy into clinical use by both military and civilian surgeons in hospitals.
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