Early specialized surgical care for gunshot wounds of major vessels in Donbas

• Published in: Angiologii͡a︡ i sosudistai͡a︡ khirurgii͡a Vol. 22; no. 2; p. 156
• Main Authors: Rozin, Yu A, Ivanenko, A A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2016
• Subjects: Adult; Amputation - methods; Amputation - statistics & numerical data; First Aid - methods; Hemostatic Techniques; Humans; Ligation - methods; Ligation - statistics & numerical data; Male; Outcome Assessment (Health Care); Reconstructive Surgical Procedures - methods; Reconstructive Surgical Procedures - statistics & numerical data; Survival Rate; Trauma Severity Indices; Triage - methods; Triage - organization & administration; Ukraine - epidemiology; Vascular Surgical Procedures - methods; Vascular Surgical Procedures - statistics & numerical data; Vascular System Injuries - diagnosis; Vascular System Injuries - mortality; Vascular System Injuries - surgery; Wounds, Gunshot - diagnosis; Wounds, Gunshot - mortality; Wounds, Gunshot - surgery; Ukraine
• ISSN: 1027-6661

The authors share their experience gained in rendering early specialized surgical care during combat operations in Donbas, having operated on a total of 139 wounded with lesions of large vessels, of these, 21 (15.1%) presenting with concomitant lesions of vessels. Reconstructive operations were carried out in 122 (87.8%) wounded, ligating operations - in 12 (8.6%), and primary amputations - in 5 (3.6%). Two (1.4%) patients died. Blood flow was restored in 117 (84.2%) patients, with six amputations performed after primary operations. The limb was saved in 116 (83.4%) wounded. Peculiarities of a vascular injury in Donbas comprise a large proportion of severe concomitant vascular wounds and lack of intermediate stages of evacuation. The prognosis of life and limb salvage largely depends on correctly chosen method of temporary arrest of bleeding at first stages of medical evacuation and shortening the terms of rendering first specialized surgical care. The variant of operation (reconstruction, ligation or primary amputation) in severe concomitant vascular wounds should be determined proceeding from the degree of ischaemia and severity of the condition of the wounded person, assessed by means of the Military Surgery - Mangled Extremity Severity Score.