First contact surgery in the treatment of patients with gunshot and explosive wounds of limbs
https://doi.org/10.51922/1818-426X.2023.2.120
Abstract
Gunshot wounds of extremities are the most frequent among gunshot and explosive injuries. Debridement is the main method of treatment of this type of damage. Surgeons of civil hospital organizations have difficulties in determining the scope of surgical intervention and the priority of the performed activities in most cases. This is due to the lack of clinical experience in providing medical care to patients with a gunshot injury. The concept of «First contact surgery» is a set of the minimum required amount of the debridement aimed at saving the patient's life and preventing the development of serious complications. The author considers in details the content of each element of the debridement, options for its implementation, depending on the equipment of the hospital and the surgeon's qualifications. The main aims for the surgeon at the first contact with a patient with a gunshot injury are to stop external bleeding, determine the state of the main blood flow in the limb, eliminate uncompensated ischemia of the limb, wide the wound open, refuse the primary wound suture, perform immobilization, if necessary, and prescribe antibiotic therapy.
About the Author
A. P. Trukhan
ГУ «432 ордена Красной Звезды главный военный клинический медицинский центр Вооруженных Сил Республики Беларусь»
Belarus
Belarus
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Review
For citations:
Trukhan A.P. First contact surgery in the treatment of patients with gunshot and explosive wounds of limbs. Medical Journal. 2023;(2):120-123. (In Russ.) https://doi.org/10.51922/1818-426X.2023.2.120
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