The use of Negative Pressure Wound Therapy in the Treatment of Military Blast Wounds/High-Velocity GSW Wounds of the Extremities

Background: Since the beginning of the full-scale Russian-Ukrainian war, a large number of soldiers and civilians have received blast wounds/GSW wounds to their extremities, which required long-term treatment. Most of these patients required staged debridement of these wounds and implementing negative pressure wound therapy. Purpose: Due to the high intensity of modern war hospitals are faced by many challenges - huge numbers of patients with open fractures with soft and bone tissue defects, personnel shortage, long evacuation hours, patients with tourniquet syndrome. The purpose of this study was to point out the effectiveness of the use of negative pressure wound therapy in the treatment of war wounds in the front line hospital. Methods: This is a retrospective case series study, which was conducted among war injured patients. Treatment strategy is the usage of multiple debridements in combination with NPWT. The pressure of the VAC systems ranged from 90 to 130 mm Hg, 120 mm Hg being the average. Wound VACs were changed every 3-5 days. Treatment goals were staged wound closure or wound preparation for complex reconstructive surgery. During this study we used several criteria to evaluate successful treatment – WBC, soft tissue conditions, wound closure with no inflammation signs. Results 1. Debridement in combination with NPWT gives great results in staged wound closure. 2. NPWT eliminates daily dressing changes which allows a large number of doctors to participate in urgent care of the wounded and reduces the load on medical staff. 3. NPWT provides active wound care during evacuation stages. 4. NPWT is extremely important in tourniquet syndrome management (helps to differentiate between viable/non-viable tissues). Conclusions: NPWT is of great importance during war time. NPWT makes it possible to perform multiple life and limb saving surgeries despite medical staff shortage and huge admission rates.