Search for new options to improve the treatment of pelvic organ injuries in civilian gunshot wounds sustained in localized armed conflicts
- Authors: Polidanov M.A.1,2, Volkov K.A.3, Maslyakov V.V.4,5, Sidelnikov S.A.4
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Affiliations:
- Saratov State Medical University named after V. I. Razumovsky
- Saratov Medical University "Reaviz"
- Saratov State Medical University named after V.I. Razumovsky
- Saratov State Medical University named after V. I. Razumovsky of the Ministry of Health of the Russian Federation
- Saratov Medical University «Reaviz»
- Issue: Vol 13 (2024): Материалы XX Международного Бурденковского научного конгресса 18-20 апреля 2024 года
- Pages: 137-138
- Section: Военная и экстремальная медицина
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/9175
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Abstract
Introduction. Unfortunately, armed conflicts still do not cease to occur in the modern world. There is no doubt that under such conditions not only military personnel directly involved in hostilities, but also the civilian population is injured. The aim of the study was to search for new options to improve the treatment of pelvic organ injuries in gunshot wounds of the civilian population received in the conditions of localized armed conflict. Materials and Methods. The study included 112 wounded and civilian population who received gunshot wounds in the pelvic region. The injured in different periods of armed conflicts were included: on the territory of Grozny (Chechen Republic) in the period from 2000 to 2003 and on the territory of Lugansk People's Republic, Donetsk People's Republic, Zaporizhzhya and Kherson regions during a special military operation. Of the total number of wounded men were 64 (57.1%), women - 48 (42.8%). Methods of descriptive statistics were used for mathematical processing. The criterion used was the criterion of agreement χ2. Results. All pelvic wounds can be conditionally divided into three groups: wounds of external genital organs, wounds of internal pelvic organs, and wounds of external genital organs and internal organs. Complications in case of wounds to this anatomical region occur in 34.8%, and lethality is 18.7%. Conclusions. The conducted analysis showed that the measures aimed at providing first aid to the wounded female patients in the pelvic region were fully rendered by medical teams, and no errors in the performance of these measures were registered, which testifies to the good training of emergency physicians.
Full Text
Introduction. Unfortunately, in the modern world armed conflicts still do not cease to arise. There is no doubt that under such conditions not only servicemen directly participating in military actions, but also the civilian population are injured [1-3] At the same time, the civilian population accounts for a greater proportion of fatalities and complications than servicemen [4, 5].
The aim of the work was to find new options to improve the treatment of pelvic organ injuries in gunshot wounds of the civilian population received in the conditions of local armed conflict.
Materials and Methods of the Study. The study included 112 wounded and civilians who received gunshot wounds in the pelvic region. The injured in different periods of armed conflicts were included: on the territory of Grozny (Chechen Republic) in the period from 2000 to 2003 and on the territory of the Lugansk People's Republic, Donetsk People's Republic, Zaporizhzhya and Kherson regions during a special military operation. Of the total number of wounded men there were 64 (57.1%), women - 48 (42.8%). All the wounded with penetrating character in the given anatomical area, whose age was not less than 18 years, were included. The wounded with combined injuries of the head, chest, and extremities were excluded. Medical histories of the wounded were used as primary documentation. A three-degree shock scale was used in the study. Assessment of the condition of the injured was carried out using the CAP-SP scale. For mathematical processing, the results of the study were initially entered into an electronic database; the results of the study were analyzed using the method of descriptive statistics. The χ2 criterion of agreement was used as a criterion.
Results of the study. All pelvic wounds can be conditionally divided into three groups: wounds of external genital organs, wounds of internal pelvic organs, and wounds of external genital organs and internal organs. It was found that 87 (77.7%) gunshot wounds predominated, whereas bullet wounds were found in 25 (22.3%) observations (r = 0.76, p < 0.05). In addition, multiple injuries predominated, the frequency of which amounted to 98 (87.5%) cases, whereas isolated injuries occurred in only 14 (12.5%) observations (r = 0.87, p < 0.05). Complications of wounds to this anatomical region occurred in 34.8%, and lethality was 18.7%. The main cause of lethal outcomes was traumatic shock - 10 (8,9%), unrelieved peritonitis - 8 (7,1%), sepsis - 4 (3,6%) and pulmonary embolism - 3 (2,7%). Thus, the presented study shows that gunshot wounds to the pelvic region are severe wounds accompanied by quite a large number of complications and fatalities.
Conclusion. Gunshot wounds of the small pelvis in women are accompanied by a large number of complications and lethal outcomes, the number of which depends on the time of wounding and the start of surgical treatment
About the authors
Maxim Andreevich Polidanov
Saratov State Medical University named after V. I. Razumovsky; Saratov Medical University "Reaviz"
Author for correspondence.
Email: maksim.polidanoff@yandex.ru
ORCID iD: 0000-0001-7538-7412
SPIN-code: 2629-7545
laboratory assistant of the Department of Mobilization Training of Public Health and Disaster Medicine; Postgraduate student of the Department of Surgical Diseases, laboratory assistant of the Research Department
Russian Federation, 410012, Volga Federal District, Saratov Region, Saratov, 112 Bolshaya Kazachya St.; 410012, Volga Federal District, Saratov Region, Saratov, Verkhny rynok St., 10.Kirill Andreevich Volkov
Saratov State Medical University named after V.I. Razumovsky
Email: kvolee@yandex.ru
ORCID iD: 0000-0002-3803-2644
SPIN-code: 1127-3119
2nd year student of the Faculty of Medicine
Russian Federation, 410012, Volga Federal District, Saratov Region, Saratov, 112 Bolshaya Kazachya St., 112Vladimir Vladimirovich Maslyakov
Saratov State Medical University named after V. I. Razumovsky of the Ministry of Health of the Russian Federation; Saratov Medical University «Reaviz»
Email: maslyakov@inbox.ru
ORCID iD: 0000-0001-6652-9140
SPIN-code: 4232-3811
Doctor of Medical Sciences, Professor, Professor of the Department of Mobilization Training of Public Health and Disaster Medicine; Doctor of Medical Sciences, Professor, Professor of the Department of Surgical Diseases
Russian Federation, 410012, Volga Federal District, Saratov Region, Saratov, 112 Bolshaya Kazachya St.; 410012, Volga Federal District, Saratov Region, Saratov, Verkhny rynok St., 10.Sergey Alekseevich Sidelnikov
Saratov State Medical University named after V. I. Razumovsky of the Ministry of Health of the Russian Federation
Email: ssidelnikov@mail.ru
ORCID iD: 0000-0002-9913-5364
SPIN-code: 8838-9282
MD, Associate Professor, Head of the Department of Mobilization Training of Healthcare and Disaster Medicine
Russian Federation, 410012, Volga Federal District, Saratov Region, Saratov, 112 Bolshaya Kazachya St.References
- Полиданов, М.А., Кондрашкин, И.Е., Волков, К.А., Масляков, В.В., Паршин, А.В. Характеристика видов оказания первой помощи при ранениях малого таза у женщин, полученных в условиях локального военного конфликта // М.А. Полиданов, И.Е. Кондрашкин, К.А. Волков, В.В. Масляков, А.В. Паршин // В сборнике: Week of Russian science (WeRuS-2023). Сборник материалов ХII Всероссийской недели науки с международным участием, посвященной Году педагога и наставника. Редколлегия: Н.А. Наволокин, А.М. Мыльников, А.С. Федонников. Саратов. – 2023. – 224 с.
- Бойко, В.В., Замятин, П.Н., Мирошниченко, Ю.И. и др. Хирургическое лечение повреждений органов малого таза и забрюшинного пространства в условиях массивной кровопотери / В.В. Бойко, П.Н. Замятин, Ю.И. Мирошниченко и др // Вестник хирургии Казахстана. – 2014. – Т. 4. – № 40. – С. 34-37.
- Масляков, В.В., Салов, И.А., Сидельников, С.А., Барачевский, Ю.Е., Паршин, А.В., Полиданов, М.А. Характеристика видов первой помощи при ранениях малого таза у женщин, полученных в условиях локального военного конфликта / В.В. Масляков, С.И. Салов, С.А. Сидельников, Ю.Е. Барачевский, А.В. Паршин, М.А. Полиданов // Журнал им. Н.В. Склифосовского Неотложная медицинская помощь. – 2023. № 12 (4). – С. 601–606.
- Масляков, В.В., Салов, И.А., Сидельников, С.А., Урядов, С.Е., Паршин, А.В., Барсуков, В.Г., Полиданов, М.А., Пападопулос, Х.Д., Петрич, А.В. Оптимизация хирургического лечения огнестрельных ранений малого таза с повреждением внутренних половых органов у женщин / В.В. Масляков, И.А. Салов, С.А. Сидельников, С.Е. Урядов, А.В. Паршин. В.Г. Барсуков, М.А. Полиданов, Х.Д. Пападопулос, АВ. Петрич // Политравма / Polytrauma. – 2023. – № 4. – С. 13-19.
- Громов, М.С., Керимов, А.З. Хирургическая тактика при огнестрельных ранениях живота в условиях регионального конфликта / М.С. Громов, А.З. Керимов // Саратовский научно-медицинский журнал. – 2010. – № 6 (2). – С. 460-462.
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