[Treatment of victims with mine-explosive injuries].

Objective: To study the incidence and structure of combat gunshot surgical trauma received during the 2 Karabakh War and to analyze the results of treatment of these victims.

Material And Methods: We analyzed surgical treatment of 60 victims with combat gunshot surgical trauma received during the 2 Karabakh war. In 25 (41.7%) victims, injury occurred as a result of mine-explosive trauma. These victims were divided into 3 groups depending on mechanism of mine-explosive injury. The 1 group included 7 (28%) patients who received mine-explosive injury due to indirect (propelling) effect of blast wave. The 2 group included 14 (56%) victims in whom mine-explosive injury was caused by non-contact (distant) impact of mine fragments. The 3 group consisted of 4 (16%) patients whose mine-explosive injuries were caused by direct impact of explosion factors on various anatomical areas. Patients were also ranked into 3 groups depending on the nature and severity of mine-explosive injury: wounded with isolated injuries (=16, 64%), wounded with concomitant injuries (=2.8%), wounded with combined and multiple injuries (=7, 28%).

Results: Most patients underwent organ-sparing procedures. Resections were performed only in 4 cases (splenectomy - 3, nephrectomy - 1). Postoperative complications developed in 23 (38.3%) wounded (suppuration of postoperative wounds - 13, post-traumatic pleuritis - 5, clotted hemothorax - 2, subphrenic abscess - 1, phlegmon of perineum and perianal region - 2). Mortality rate was 1.7%.

Conclusion: Timely sorting and evacuation of victims, early qualified surgical care and correct postoperative management with monitoring of vital functions can improve the results of treatment of victims with mine-explosive trauma. Autologous skin grafting for extensive defects and closure of colostomy with restoration of colon continuity were essential in rehabilitation of these patients.