Analysis of the structure and features of traumatic injuries in victims with combat trauma

Авторы

DOI:

https://doi.org/10.26641/2307-0404.2025.2.333655

Ключевые слова:

mine-explosive trauma, gunshot trauma, traumatic injuries, bleeding

Аннотация

The aim of this study was to determine the structure and characteristics of traumatic injuries in patients with mine-blast and gunshot wounds, serving as a basis for developing a comprehensive approach to medical care. The study included 127 individuals with combat-related injuries who received treatment at a healthcare facility between February 24, 2022, and October 30, 2023. Medical records, including case histories and reporting forms, were analyzed. The structure and localization of injuries, types of trauma, and the frequency of combined and multiple injuries were assessed. Statistical analysis was performed using MS Office Excel (2010) and STATISTICA v.6.1 (Statsoft Inc., USA). In this study, the nature of traumatic injuries in hos­pitalized patients with mine-blast and gunshot wounds was analyzed. Results: 45.7% of patients sustained combined or multiple injuries, while 54.3% had injuries limited to a single anatomical region. The most common injury traumas of were the chest (18.9%), head and neck (16.5%), and abdomen (14.2%). Penetrating wounds to the chest and head were often associated with more severe consequences, such as pneumohemothorax and traumatic brain injuries. In mine-blast injuries, non-penetrating trauma predominated, in particular injuries of the extremities and pelvic bones, observed in 80 patients. A significant proportion of patients also experienced bleeding, exceeding 750 ml, which led to hemorrhagic shock in 63.6% of cases. The overall mortality rate was 13.4%, with most deaths occurring in the early stages of treatment, primarily due to the severity of injuries and the development of purulent-septic complications. Combat trauma is predominantly associated with mine-explosive mechanisms, characterized by a high frequency of multiple and combined injuries, significantly complicating the provision of medical care and necessitating a multidisciplinary approach.

Библиографические ссылки

Tin D, Barten DG, Granholm F, Kovtonyuk P, Burkle FM, Ciottone GR. Hybrid warfare and counter-terrorism medicine. European Journal of Trauma and Emergency Surgery. 2023;2:583-93. doi: https://doi.org/10.1007/s00068-023-02230-y

Jarrassier A, Py N, de Rocquigny G, Raux M, Lasocki S, Dubost C, et al. Lessons learned from the war in Ukraine for the anesthesiologist and intensivist: A scoping review. Anaesthesia Critical Care & Pain Medicine. 2024 Jul 30;43(5):101409. doi: https://doi.org/10.1016/j.accpm.2024.101409

Spagnolello O, Gatti S, Shahir MAA, Afzali MF, Portella G, Baiardo Redaelli M. Civilian war victims in Afghanistan: five-year report from the Kabul EMERGENCY NGO hospital. European Journal of Trauma and Emergency Surgery. 2022 Nov 30;49(3):1401-5. doi: https://doi.org/10.1007/s00068-022-02137-0

Kuchyn I, Horoshko V. Chronic pain in patients with gunshot wounds. BMC Anesthesiol. 2023;23(1):47. doi: https://doi.org/10.1186/s12871-023-02005-3

Wightman JM, Springer BL, Pickett JR. Blast injury management for operators and tactical emergency medical support providers. The Tactical Edge [In¬ternet]. 2018 [cited 2025 Mar 07];(Fall):74-8. Available from: https://www.researchgate.net/publication/361594434_Blast_injury_management_for_operators_and_TEMS_providers

Kobayashi L, Coimbra R, Goes AMO Jr, et al. American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of peripheral vascular injuries. J Trauma Acute Care Surg. 2020;89(6):1183-96. doi: https://doi.org/10.1097/TA.0000000000002967

Alarhayem AQ, Cohn SM, Cantu-Nunez O, Eas-tridge BJ, Rasmussen TE. Impact of time to repair on outcomes in patients with lower extremity arterial injuries. J Vasc Surg. 2019;69(5):1519-23. doi: https://doi.org/10.1016/j.jvs.2018.07.075

[On approval of the procedures for providing first aid to persons in emergency conditions. Order of the Ministry of Health of Ukraine dated 2022 Mar 9 No. 441]. [Internet]. 2022 [cited 2025 Mar 07]. Ukrainian. Available from: https://zakon.rada.gov.ua/laws/show/z0356-22#Text

Owens BD, Kragh JF Jr, Wenke JC, Macaitis J, Wade CE, Holcomb JB. Combat wounds in operation Iraqi Freedom and operation Enduring Freedom. J Trauma. 2008;64(2):295-9. doi: https://doi.org/10.1097/TA.0b013e318163b875

Khomenko IP, Korol SO, Khalik SV, Shapovalov VY, Yenin RV, Нerasimenko OS, Tertyshnyі SV. Cli-nical and Epidemiological analysis of the structure of combat surgical injury during Antiterrorist operation “Clinical and Epidemiological Analysis of the Structure of Combat Surgical Injury During Antiterrorist Operation. Joint Forces Operation. Ukrainian Journal of Military Medicine. 2021;2(2):5-13. doi: https://doi.org/10.46847/ujmm.2021.2(2)-005

Trentzsch H, Goossen K, Prediger B, Schwei-gkofler U, Hilbert-Carius P, Hanken H, et al. Stop the bleed “ – Prehospital bleeding control in patients with mul¬tiple and/or severe injuries – A systematic review and clinical practice guideline – A systematic review and clinical practice guideline. European Journal of Trauma and Emergency Surgery. 2025 Feb 5;51(1):92. doi: https://doi.org/10.1007/s00068-024-02726-1

O'Banion LA, Dirks R, Saldana-Ruiz N, et al. Contemporary outcomes of traumatic popliteal artery injury repair from the popliteal scoring assessment for vascular extremity injury in trauma study. J Vasc Surg. 2021;74(5):1573-80.e2. doi: https://doi.org/10.1016/j.jvs.2021.04.064

Patel JA, White JM, White PW, Rich NM, Ras-mussen TE. A contemporary, 7-year analysis of vascular injury from the war in Afghanistan. J Vasc Surg. 2018;68(6):1872-9. doi: https://doi.org/10.1016/j.jvs.2018.04.038

Danford JR, Reyes F, Gurney JM, Smith JP, Stinner DJ. Optimizing Advanced Trauma Life Support (ATLS®) to Maximize Readiness. Mil Med. 2024 Aug 30;189(9-10):e2206-10. doi: https://doi.org/10.1093/milmed/usae073

Pape HC, Lefering R, Butcher N, et al. The definition of polytrauma revisited: An international consensus process and proposal of the new 'Berlin definition. J Trauma Acute Care Surg. 2014;77(5):780-6. doi: https://doi.org/10.1097/TA.0000000000000453

Chen Y, Liu Z, Zhang P, Huang W. [Consistency of injury severity scores in patients with severe trauma]. Medical and health technology. 2024;56(1):157-60. Chinese. doi: https://doi.org/10.19723/j.issn.1671-167X.2024.01.024

Hardy BM, Varghese A, Adams MJ, Enninghorst N, Balogh ZJ. The outcomes of the most severe polytrauma patients: a systematic review of the use of high ISS cutoffs for performance measurement. Eur J Trauma Emerg Surg. 2024;50(4):1305-12. doi: https://doi.org/10.1007/s00068-023-02409-3

Опубликован

2025-06-27

Как цитировать

1.
Denysiuk M, Dubrov S, Poniatovska H, Lianskorunskyi V. Analysis of the structure and features of traumatic injuries in victims with combat trauma. Med. perspekt. [Интернет]. 27 июнь 2025 г. [цитируется по 5 декабрь 2025 г.];30(2):156-63. доступно на: https://journals.uran.ua/index.php/2307-0404/article/view/333655

Выпуск

Раздел

CLINICAL MEDICINE