SURGICAL TREATMENT OF VICTIMS WITH MINE AND EXPLOSIVE INJURIES DURING MILITARY ACTIONS

Abstract

Summary. Mine-explosive injury is a gunshot combined multiple injury that occurs in a person as a result of the impact of the impact factors of the explosion of engineering, mine ammunition and is accompanied by deep and widespread tissue damage and contusion. The purpose of the work is to analyze the methods of surgical treatment of patients with mine-explosive injuries in the conditions of martial law. Materials and methods. The results of surgical treatment of 64 patients with mine-explosive injuries were analyzed, 27 (42.2 %) were women, 37 (57.8 %) were men, who were being treated at Dergachiv Central Hospital. All victims underwent surgical interventions depending on the location of the injury, its nature, the severity of the patient, the development of traumatic or hemorrhagic shock. Results and their discussion. Given that the most frequent type of injuries were wounds of various localization, the most common type of surgical intervention was surgical treatment of wounds. The scope of the intervention depended on the depth and size of the wound, as well as the nature of tissue damage. Surgical manipulations on the chest were performed to eliminate pneumothorax (pneumohydrothorax), pleural puncture was performed or pleural drainage was established. If the Rouvilois-Gregoir test was positive, a thoracotomy was performed followed by suturing of the lung wound. Invasive diagnostic methods, laparocentesis and laparoscopy were performed for suspicion of damage to the organs of the abdominal cavity, with the help of which damage to the organs of the abdominal cavity was excluded. The use of laparocentesis in such situations, although its diagnostic value is lower than that of video laparoscopy, allows to determine the pathological content in the abdominal cavity, which is sufficient to detect life-threatening consequences of abdominal injuries, for example, such as intra-abdominal bleeding. Conclusions. Victims with explosive lesions require a large number of surgical interventions in various anatomical areas. When providing assistance to victims of an explosive injury, one should be guided by the principles of “damage control”, determining the amount of interventions that should be performed based on vital indications.