Complex Treatment of Gunshot Injuries of Soft Tissue of the Extremities Using Primary Reconstructive Surgical Interventions (Experimental Study)

INTRODUCTION: A complex approach to the treatment of gunshot wounds permits early cor-rection of both systemic metabolic and regional vascular disorders conditioned by peculiarities of the injuring agents and the character of gunshot wounds. An increase in the incidence and prominence of purulent-septic complications being one of the main challenges in treatment of gunshot wounds, directly depends on the severity of tissue damage and the extent of impairment of the regional blood flow, that is, on the severity of tissue hypoxia. AIM: Microscopic assessment of the dynamics of the wound process depending on the type of therapy with the aim of improving the results of treatment of patients with gunshot wounds of the upper extremities. MATERIALS AND METHODS: We conducted an experimental study on 20 rabbits with a model of a gunshot wound of a thoracic limb. Rabbits of group 1 were treated using the technol-ogy of complex primary reconstructive and anti-ischemic therapy, rabbits of group 2 — using the traditional scheme of surgical treatment. In the course of experimental study, histological materi-al was collected to assess morphological alterations at different stages of treatment depending on the type of therapeutic modality. RESULTS: We have established that the course of a gunshot wound healing process is to a large extent determined by the severity of wound and the amount of damage both at the macroscopic and microscopic levels. This is primarily due to better perfusion of damaged muscle tissue due to a less (or completely absent) block of microcirculatory vessels and preservation of normal cellu-lar structure throughout the entire treatment stage. CONCLUSION: Under equal experimental conditions in terms of the character and severity of the inflicted wound, we obtained the data that in group 1 the wound process runs with less pro-nounced morphological changes. Prolongation of microcirculation vessel spasm is the main pre-dictor of muscle tissue ischemia and, as a result, formation of necrosis. In group 2, pronounced necrotic and inflammatory changes persisted throughout the experiment thus delaying transition of the wound process to the regeneration phase.