ORGANIZATION OF DIAGNOSTIC AND DYNAMIC OBSERVATION DURING RECONSTRUCTIVE RESTORATION OF GUNSHIRTING SOFT TISSUES

  • I. P. Khomenko
  • Ye. V. Tsema
  • К. V. Gumenuk
  • S. V. Tertyshnyi
  • V. Yu. Shapovalov
Keywords: multimodal approach, reconstruction of soft tissue gunshot wound, perforated vessel, flap.

Abstract

Summary. Damage to the soft tissues of the human body is found both in peacetime and during the war, but the firearms nature has become relevant for Ukraine. Despite the experience gained surgery from previous wars in the treatment of gunshot injuries, there is still no generally accepted diagnostic scheme and classification for reconstructive closure of such specific injuries.

The aim. Demonstrate the features of various methods for diagnosing gunshot wounds of soft tissues proposed for reconstruction of a damaged area.

Results. In order to improve the quality of surgical care at the stages of medical evacuation, it is always necessary to carry out diagnostic procedures and treatment together. Sometimes it is impossible to implement medical care — it is on the front line, sometimes there is a lack of material resources — in the CDL, but it must be understood that the amount of diagnosis and treatment of a gunshot wound with soft tissue damage is always a difficult process.

Conclusions. A multimodal approach to diagnostics and dynamic observation in the reconstruction of soft tissue gunshot injury not only restores the integrity of the damaged anatomical structure but also increases the percentage of functional capacity.

References

1. Єрюхін І.А., Жирновой В.М. Хрупкін В.І. Патогенез та лікування вогнепальних ран м’яких тканин // Вісник хірургії. 1990.- Т. 145, № 8. – С. 53-58.
2. Шаповалов В.М., Овденко А.Г., Вогнепальний остеомієліт // «Морсар АВ» ,2000 р. – С. 65-68.
3. Domanleckl J., Orlowski T., Prizystasz T. Gunshot wounds caused by modern firearms in the light of our investigations // J. Trauma .1988. –Vol.28, N 1 .- P.163-165
4. Perforator flap Second edition Anatomy Technique and Clinical Applications , Phillip N. Blondeel Steven F. Morris Geoffrey G.Hallock Peter C. Neligan , volume II ,2013 p 1247 - 1250.
5. Phillips TJ, Stella DL, Rozen WM, Ashton MW, et al. Abdominal wall CT angiography: a detailed account of a newly established preoperative imaging technique. Radiology 249:3244, 2008. A detailed account of CT angiography for the abdominal wall donor site was presented, focusing on radiologic techniques for obtaining the best results. Patient selection, patient positioning, scanning protocols, and software reconstructions were discussed.
6. Ribuffo D, Atzeni M, Saba L, et al. Angio computed tomography preoperative evaluation for anterolateral thigh flap harvesting. Ann Plast Surg 62:368-371, 2009.
7. Rozen WM, Garcia-Tutor E, Alonso-Burgos A, Ashton MW, et al. Planning and optimising DIEP flaps with virtual surgery: the Navarra experience. J Plast Reconstr Aesthet Surg 63:289-293, 2008.
8. Rozen WM, Ribuffo D, Atzeni M, Ashton MW, et al. Current state of the art in perforator flap imaging with computed tomographic angiography. Surg Radiol Anat 31:631-639, 2009. CT angiography techniques were presented for imaging a range of perforator flaps in various body regions. Regions were compared for the accuracy of reporting and the efficacy of imaging for operative planning.
9. Taylor GI, Palmer JH. The vascular territories (angiosomes) of the body: experimental study and clinical application. Br J Plast Surg 40:113-141, 1987.
10. Yoshimura M, Shimamura K, Iwai Y, et al. Free vascularized fibular transplant. A new method for monitoring circulation of the grafted fibula. J Bone Joint Surg 65:1295-1301, 1983. A method for monitoring the buried vascularized fibular bone graft was described. It involved observing the peroneal.
Published
2020-04-20
How to Cite
Khomenko, I. P., Tsema, Y. V., Gumenuk К. V., Tertyshnyi, S. V., & Shapovalov, V. Y. (2020). ORGANIZATION OF DIAGNOSTIC AND DYNAMIC OBSERVATION DURING RECONSTRUCTIVE RESTORATION OF GUNSHIRTING SOFT TISSUES. Kharkiv Surgical School, (2), 119-126. https://doi.org/10.37699/2308-7005.2.2020.24
Section
QUESTIONS OF SURGICAL TREATMENT OF GUNSHOT WOUNDS