Organization of stage rehabilitation of servicemen with gunshot defects of soft tissues at the levels of medical care

K.D. Babov; I.P. Khomenko; S.V. Tertyshnyi; Babova I.K. Babova I.K.; R.S.  Vastianov

doi:10.26641/2307-0404.2021.4.248228

Authors

K.D. Babov SI «Ukrainian Research Institute of Medical Rehabilitation and Resort Therapy of the Ministry of Health of Ukraine», Lermontovskyi lane, 6, Odessa, 65014, Ukraine https://orcid.org/0000-0003-2066-6152
I.P. Khomenko Ministry of Defence of Ukraine, Povitroflotskyi aven., 6, Kyiv, 03168, Ukraine https://orcid.org/0000-0002-8199-5083
S.V. Tertyshnyi Odessa National Medical University, Valikhovskyi lane, 2, Odessa, 65026, Ukraine https://orcid.org/0000-0002-4949-5409
Babova I.K. Babova I.K. SI «South Ukrainian National Pedagogical University named after K.D. Ushynsky», Staroportofrankivska str., 26, Odessa, 65026, Ukraine https://orcid.org/0000-0003-1018-8302
R.S. Vastianov Odessa National Medical University, Valikhovskyi lane, 2, Odessa, 65026, Ukraine https://orcid.org/0000-0001-8585-2517

DOI:

https://doi.org/10.26641/2307-0404.2021.4.248228

Keywords:

staged rehabilitation, servicemen, gunshot wounds, soft tissue defects

Abstract

Building a modern system of rehabilitation of servicemen in Ukraine is an integral part of providing medical care in armed conflict. Rehabilitation of servicemen after gunshot wounds with soft tissue defects of the lower extremities is a common but difficult problem for surgical and rehabilitation teams. The process of rehabilitation requires the implementation of certain methodological provisions. At present, medical care for servicemen is a four-levels’ one. Rehabilitation service is provided at the third and fourth levels of medical care. The aim of the study was to improve the quality of medical care for servicemen after gunshot wounds with soft tissue defects of the lower extremities by introducing a system of staged rehabilitation. Organizational and methodological bases of the system of staged rehabilitation of wounded servicemen with soft tissue defects at different levels of medical care have been developed. Two models of rehabilitation depending on the severity of the injury and the tactics of surgical treatment are proposed. The division of the stage of early sanatorium rehabilitation for the wounded with severe soft tissue injuries depending on the stage of surgical treatment and the formation of a "skin patch" is justified. The introduction of the proposed models of rehabilitation of wounded with soft tissue defects in the practice of early sanatorium rehabilitation will provide increasing of medical care quality.

References

Zarutskyi YaL, Аslanyan SА, Zhovtonozhko ОІ, Оliinyk YuМ, Forostyanyi PP, Honcharuk VS, Vovk МS. [Аnatomical-functional scale of estimation of the trauma severity in wounded persons with thoracoabdominal injuries in environment of conduction of the Joint Armed Forces Operation]. Klinichna khirurhiia. 2020 January/February;87(1-2):3-7. Ukrainian. doi: https://doi.org/10.26779/2522-1396.2020.1-2.03

Babova ІК. [Rehabiliation of patients after hip joint replacement (in specialized rehabilitation depart¬ment)]. Monographiia. Odessa: Poligraf; 2020;152. Ukrainian.

Babova ІК, Rozkov VS. [Sanatorium-resort rehabilitation of servicemen in Ukraine: public-admi¬nistration aspect]. Publichne upravlinnia i administruvannia v Ukraini. 2020;19:21-26. doi: https://doi.org/10.32843/pma2663-5240-2020.19.4

[Military medical doctrine of Ukraine]. postanova Kabinetu ministriv Ukrainy No. 910, 31.10.2018. Uk¬rainian. Available from: https://zakon.rada.gov.ua/laws/show/910-2018-%D0%BF#Text

Kovaliova LN. [Modern differentiated approach to complex treatment and prevention of skin scars of different etiology]. Dermatovenerologiia. Kosmetologiia. Seksologiia. 2016;1-4:188-98. Russian. Available from: https://repo.dma.dp.ua/3178/1/18_Kovalyova_38.pdf

Savitskiy VL, Maiduniuk VP, Vlasenko ОМ, Stri¬zhenko VІ, Bulah ОYu.. [Medical support of the Armed Forces of Ukraine in the anti-terrorist operation: experience and areas for improvement]. Viiskova medycyna Ukrainy. 2015;1(15):5-11. Available from: https://odmu.edu.ua/xmlui/bitstream/handle/123456789/8225/Maidaniuk.pdf?sequence=1&isAllowed=y

[About the statement of the Instruction on the organization of sanatorium treatment, medical and medico-psychological rehabilitation in the Armed Forces of Ukraine]. Nakaz Ministerstva oborony Ukrainy vid No. 591, 04.11.2016. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/z1538-16#n12.

[About rehabilitation in health care sphere]. Zakon Ukrainy No. 1053-IX, 03.12.2020. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/1053-20#Text

[About social and low defense of servicemen and members of their families]. Zakon Ukrainy No. 2011-XII, 1991.12.20. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/2011-12#Text.

Babova КD, Pіnchuk ІYa, Stebluka VV., editors. [Rehabilitation of victims in emergencies and armed conflicts. Post-traumatic stress disorder]. Monographiia. Odessa: Poligraf; 2015. p. 240. Ukrainian.

[Annual national program Річна національна програма under the auspices of the Commission Ukraine-NATO on 2021 year]. Ukaz Presidenta Ukrainy No. 189/2021, 2021.05.11. Ukrainian. Available from: https://www.president.gov.ua/documents/1892021-38845.

Poter SB., editor. [Physiotherapy. Classical course]. Ponomarenko GN., editor eng. Sankt-Peterburh: Chelovek; 2014. p. 764. Russian.

Bayat M. The Need for Increased Attention to Low‐Level Laser Therapy as Treatment for Wounds and Ulcers, Wound Healing. New insights into Ancient Challenges. Alexandrescu VA. 2016;399-414. doi: https://doi.org/10.5772/64339

Feily A, Moeineddin F, Mehraban S. Physical Modalities in the Management of Wound(s), Wound Healing. New insights into Ancient Challenges. Alexandrescu VA. 2016;361-72 doi: https://doi.org/10.5772/64340

Hoyt BW, Pavey GJ, Pasquina PF, Potter BK. Rehabilitation of Lower Extremity Trauma: a Review of Principles and Military Perspective on Future Directions. Curr. Trauma Rep. 2015;1:50-60. doi: https://doi.org/10.1007/s40719-014-0004-5