An algorithm for treating gunshot wounds and blast injuries to limbs with soft tissue defects

The active modernization of weapons carried out by most countries of the world and the change in combat tactics have led to a change in the nature of combat trauma. In modern local armed conflicts, gunshot wounds and blast limb injuries are characterized by significant destruction and damage to soft tissues with extensive defects requiring reconstructive plastic replacement. Purpose: to increase the effectiveness of the treatment of limb gunshot wounds and blast lesions with soft tissue defects. Material and methods. The study included 90 patients with gunshot wounds and blast injuries with extensive soft tissue defects of the extremities. All the wounded were divided into 2 groups: the 1st group (control) included 50 (55.5%) of the wounded who had the traditional treatment method; the 2nd group (comparison) included 40 (44.5%) of the wounded who received the original algorithm for the treatment of gunshot wounds and blast limb lesions. Results. It was found that when using the presented algorithm, it was possible to reduce the number of complications of plastic surgery to 15% in group 2, while this figure in group 1 was 28%. Conclusions. The application of the presented algorithm for the treatment of gunshot wounds and blast lesions of limbs with extensive soft tissue defects can increase the effectiveness of wound treatment in case of combat surgical trauma by preparing the wound for reconstructive plastic surgery in the early stages (up to 30 days) with the use of methods of local physical impact.