VACUUM DRESSINGS IN THE SURGICAL TREATMENT OF THE INJURED WITH WIDE SOFT TISSUE DEFECTS

Introduction. The problem of treating gunshot wounds and their impact has been and remains one of the most complex and urgent tasks of military surgery. One of the modern world standards in the treatment of gunshot wounds with extensive defects of soft tissues for prolonged active drainage is widespread adoption of vacuum dressings. In combination with surgical treatment, this method can effectively clean and prepare for the closure of gunshot wounds.

Aim. To improve methods and improve outcomes in the system of specialized medical care to the wounded with live surgical trauma and the presence of extensive soft tissue defects by applying WAC therapy in complex surgical treatment of victims.

Materials and methods. It analyzes the results of examination and treatment of 157 injured with gunshot wounds who were in the Military Hospital within the period from 2014 to 2017 and 52 people in the control group.

Results. The study found that the characteristics of the wound healing process in patients with soft tissue defects of different origin showed significant differences depending on microbial contamination (clean, dirty, festering wounds), features and mechanism of injury and location.

Conclusion. Results of surgical treatment of soft tissue defects in the combat surgical trauma using vacuum-dressing show that the primary intention wound healing in surveillance study group was 24.4% more than in the comparison group and the control group (p<0.01). Wound healing during the first 15 days was also significantly more affected in the main group. This decrease resulted active period and postoperative treatment period and total hospital stay of patients in treatment with the use of vacuum-dressing. It was established lesser number of postoperative complications (bleeding, fluid accumulation, festering wounds, fistulas, pain) applying vacuum therapy by 10% (p<0.05) as for control group and 17.6% (p<0.05) as for the comparison group. The largest share of complications in the study group occupy bleeding (5.5%). At the same time, festering wounds were not observed, indicating the effectiveness of cleaning the wound with the method of vacuum therapy.