Surgical treatment of wounded persons with complicated thoracic damages
Objective. To improve the results of complex surgical treatment of wounded and injured persons with thoracic trauma, complicated by bronchopleural fistulas, pleural empyema and defects in the thoracic wall soft tissues, basing on introduction of the proposed procedure of vacuum therapy in combination with bronchoscopic obturation of certain bronchus.
Materials and methods. Analysis of results of the complex surgical help delivery for 54 wounded persons with defects of the thoracic wall soft tissues, broncho-pleural fistulas and pleural empyema, caused by the combat thoracic trauma, on ІІІ and ІV levels of medical support while conduction of the Antiterrorist operation/Operation of the Joined Forces (the main group) and 73 injured persons with thoracic trauma of the peace period (the comparison group) in the 2014 - 2019 yrs period was conducted.
Results. Improvement of complex surgical treatment of the wounded and damaged persons with thoracic trauma and defects of the thoracic wall soft tissues have permitted to reduce the complications frequency by 6.7%, and lethality - by 9.2% in the main group.
Conclusion. There was proposed a procedure of vacuum therapy, ultrasound cavitation together with bronchoscopic bronchial obturation for its fistula, which have proved its efficacy in complex surgical treatment of severely wounded persons with the gun-shot thoracic damages and presence of combination of pleural empyema, bronchial fistula and defects of soft tissues.
Zarutskyi YaL, Bilyi VYa, editors. Military field surgery. Kyiv: Phoenix; 2018. 552 c. Ukrainian. ISBN: 978-966-136-624-3.
Zarutskyi YaL, Zaporozhan VM, editors. Military field surgery: textbook. Odesa: Odesa National Medical University; 2016.415 p.Ukrainian. ISBN 978-966-443-078-1.
Zarutskyi YaL, Shudrak AA, editors. Instructions on the military field. Kyiv: Chalchynska NV; 2014. 395 p. Ukrainian. ISBN 966-8126-51-3.
Belyi VYa, Zarutskiy YaL, Zhovtonozhko AI, Aslanyan SA. Essays on surgery for abdominal combat trauma. Kyiv: Lesya; 2016. 211 p. Ukrainian.
Shipilov SA. Improvement of methods of diagnostics and surgical treatment of the wounded with gunshot wounds of a diaphragm the dissertation Author’s abstract on scientific degree competition. PhD(Med) [thesis]. Kharkiv; 2020. 22 p. Ukrainian.
Haghshenasskashani A, Rahnavardi M, Yan TD, McCaughan BC. Intrathoracic application of a vacuum-assisted closure device in managing pleural space infection after lung resection: is it an option? Interact Cardiovasc Thorac Surg. 2011 Aug;13(2):168-74. doi: 10.1510/icvts.2011.267286. Epub 2011 May 20. PMID: 21602420.
Scarci M, Abah U, Solli P, Page A, Waller D, van Schil P, et al. EACTS expert consensus statement for surgical management of pleural empyema. Eur J Cardiothorac Surg. 2015 Nov;48(5):642-53. doi: 10.1093/ejcts/ezv272. Epub 2015 Aug 7. PMID: 26254467.
Aslanyan SA, Zarutskyi YaL, Sapa SA, Fomin OO, Kompaniets AO, Sidoruk DP, et al., inventors; Aslanyan SA, Zarutskyi YaL, assignee. Method irrigation, injection therapy purulent wounds of soft tissues. Patent Ukraine 132410. 2019 25 February.
Zarutskyi YaL, Karpenko KK, Aslanyan CA, Korol SO, Fomin OO, Vovk MS, et al., inventors; Zarutskyi YaL, Karpenko KK, Aslanyan CA, Korol SO, Fomin OO, Vovk MS, et al, assignee. A method of measuring the area of skin defects in their diagnosis and in the dynamics of treatment. Patent Ukraine 128624. 2018. 25 September.
Aslanyan SA, Verba AV, Zarutskyi YL, Kompaniets AO, Goncharuk VS, Sheremeta TS, et al., inventors; Aslanyan SA, Verba AV, assignee. Method of treating soft tissue wounds of chest with presence of external openings of bronchial fistulas. Patent Ukraine 129559. 201812 November.
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