Treatment of limb combat blast wounds using negative pressure

Abstract

Blast injury (BI) is a combat multifactorial injury resulting from the impulse action of the complex traumatic factors by the mine munition explosion, characterized an interconnected and increasingly severe impact, massive deep tissue damage and the development of a general contusion-shock syndrome. For severe BI with large skin and soft tissue defects, it is advisable to use negative pressure wound therapy (NPWT). Objective. To analyze the effectiveness of using the NPWT system in patients with blast injuries. Methods. Publications were searched in electronic systems Google Scholar, PubMed, ScienceDirect, archives of specialized journals. The results of treatment using NPWT of 134 patients were analyzed: 130 (97 %) men and 4 (3 %) women, average age 36.6 years (22‒64). According to the types of injuries, the patients were distributed as follows: blast injury — 128 (95.5%), bullet injuries — 6 (4.5 %). The results. The goal of BI treatment by negative pressure is to improve wound healing through multiple mechanisms of action at the macroscopic and microscopic levels. The use of NPWT reduces the risk of infectious complications, prevents excessive progression necrosis of affected tissues, accelerates the growth of granulation tissues and reduces pain syndrome. The result of the treatment is the wound preparation for primary healing or, in the case of significant soft tissue damage, the creation of favorable conditions for performing plastic surgeries. In general, NPWT accelerates treatment times, reduces risks of complication level and improves functional results. This current own research coincides with the results of majority authors and allows us to continue work in this direction. Conclusions. Treatment of blast injury wounds with the use of vacuum bandages and devices for creating negative pressure is an effective approach that contributes to the reduction of infectious complications, the growth of granulation tissue, facilitates further skin plasticity of the defect, accelerates the recovery time of the wounded and his rehabilitation.