Forensic medical analysis of child mortality due to mechanical trauma in peaceful and wartime: impact on improving surgical care

Child mortality due to mechanical trauma is a significant issue in forensic medical practice. It necessitates attention to the specifics of injuries and the organization of medical care. Firearm and explosive injuries impose additional demands on surgical care. Aim: to study the structure and causes of child mortality due to mechanical trauma based on forensic medical data, analyze changes in mortality rates before and after the onset of the full-scale military invasion, and develop proposals for improving pediatric surgical care by integrating forensic medical data into clinical practice. Materials and methods. The data from the Bureau of Forensic Medical Examination of Ukraine for 2019-2022 on violent child mortality, including mortality from mechanical trauma, were used. Pediatric mechanical injuries with potential surgical consequences were analyzed in detail during both the pre-war and wartime periods to determine the possibilities for surgical treatment under modern conditions. Results. The decrease in the violent death rates among children in 2022 was attributed to factors such as evacuation and difficulties in registering deaths under wartime conditions, particularly in temporarily occupied territories. Changes in the structure of mortality from mechanical trauma can contribute to the improvement of surgical care through the integration of forensic medical data into clinical practice. The increase in firearm and explosive injuries requires advancements in medical care methods under wartime conditions, especially in pediatric surgery. The reduction in vehicle-related injuries suggests the need to reallocate medical resources to the treatment of injuries typical of wartime. Conclusions. The decrease in violent deaths among children in 2022 is primarily due to a general reduction in Ukraine's population. However, the sharp rise in firearm and explosive injuries directly linked to active hostilities and constant shelling of medical facilities indicate the urgent need to enhance medical care methods under combat conditions, particularly in pediatric surgery.