Early specialized surgical care for gunshot wounds of major vessels in Donbas

Rozin Yu.A., Ivanenko A.A.

Institute of Emergency and Restorative Surgery named after V.K. Gusak, Donetsk, Donetsk People’s Republic

The authors share their experience gained in rendering early specialized surgical care during combat operations in Donbas, having operated on a total of 139 wounded with lesions of large vessels, of these, 21 (15.1%) presenting with concomitant lesions of vessels. Reconstructive operations were carried out in 122 (87.8%) wounded, ligating operations – in 12 (8.6%), and primary amputations – in 5 (3.6%). Two (1.4%) patients died. Blood flow was restored in 117 (84.2%) patients, with six amputations performed after primary operations. The limb was saved in 116 (83.4%) wounded.

Peculiarities of a vascular injury in Donbas comprise a large proportion of severe concomitant vascular wounds and lack of intermediate stages of evacuation. The prognosis of life and limb salvage largely depends on correctly chosen method of temporary arrest of bleeding at first stages of medical evacuation and shortening the terms of rendering first specialized surgical care. The variant of operation (reconstruction, ligation or primary amputation) in severe concomitant vascular wounds should be determined proceeding from the degree of ischaemia and severity of the condition of the wounded person, assessed by means of the Military Surgery – Mangled Extremity Severity Score.

KEY WORDS: gunshot vascular injuries, early specialized surgical care, concomitant wounds, reconstruction, amputation.

P. 160

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