Surgical care to the wounded with large bowel battle truma during the anti-terrorist operation

Kashtalyan M. A., Tkachenko A. Ye., Kvasnevskyi Ye. A., Honcharuk V. S. Surgical care to the wounded with large bowel battle truma during the anti-terrorist operation. Journal of Education, Health and Sport. 2020;10(5):290-300. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2020.10.05.031

https://apcz.umk.pl/czasopisma/index.php/JEHS/article/view/JEHS.2020.10.05.031

https://zenodo.org/record/3936035

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© The Authors 2020;

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Received: 04.05.2020. Revised: 16.05.2020. Accepted: 29.05.2020.

SURGICAL CARE TO THE WOUNDED WITH LARGE BOWEL BATTLE TRUMA DURING THE ANTI-TERRORIST OPERATION

M. A. Kashtalyan1, A. Ye. Tkachenko2, Ye. A. Kvasnevskyi1, V. S. Honcharuk2

1Odessa National Medical University, Odessa, Ukraine

2Ukrainian Military Medical Academy of the Ministry of Defense of Ukraine, Kyiv, Ukraine

M. A. Kashtalyan, MD PhD, Professor, Chief of Department of General and Military Surgery, 2, Valikhovskiy lane, Odessa 65082, Ukraine; tel. (048) 723-42-49

e-mail: mkashtalian@gmail.com;

Tkachenko Andriy, PhD, Senior lecturer of the Department of Military Surgery, Ukrainian Military Medical Academy, 45/1, Moscow St., Kyiv 01015, Ukraine; tel: (044) 280-00-34, (044) 280-01-43;

e-mail: andrtkach@bigmir.net; ORCID: https://orcid.org/0000-0002-3371-497X

Ye. A. Kvasnevskyi, Adjunct of the Department of General and Military Surgery, Odessa National Medical University, 2, Valikhovskiy lane, Odessa 65082, Ukraine; tel. (048) 723-42-49,

e-mail: arztev@icloud.com;

Honcharuk Viktor, Adjunct of the Department of Military Surgery, Ukrainian Military Medical Academy, 45/1, Moscow St., Kyiv 01015, Ukraine; tel: (044) 280-00-34, (044) 280-01-43;

e-mail: goncharukviktor87@gmail.com; ORCID: https://orcid.org/0000-0001-9803-7781

Abstract

A study of surgical treatment at the stages of medical evacuation of 83 wounded with a battle trauma to the abdomen and damage to the large bowel, received during the anti-terrorist operation. The wounded patients were divided into two groups: the comparison group — 42 patients with a traditional surgical management, and the main group — 41 patients with a priority surgical management, which depended on the severity of the condition, the severity of internal injuries and operational and tactical circumstances. At the second level of medical care, the surgical management and the extent of surgical interventions were determined: full, abbreviated or damage control surgery. At the III–IV levels of medical care, planned repeated operations “damage control surgery”, “second look”, as well as comprehensive treatment of the consequences and complications of gunshot wounds were performed.

A new approach to the choice of surgical management, as well as the standardization of the estent of surgical interventions have reduced the number of postoperative abdominal complications by 27% and mortality rate — by 16.4%.

Key words: gunshot wound; large bowel; “damage control surgery”; “second look”.