One Successful Clinical Case with a Gunshot Wound of the Popliteal Area of Our Experience in the Treatment of Injuries of Lower Extremities
Year: 2022
Type: article
Study design: Case Report
Abstract: Introduction: Gunshot wounds (GSW) of the main vessels remain relevant and sophisticated sphere of vascular surgery both, in therapeutic and organizational way. Since the beginning of military conflict on the East of Ukraine the account of vascular trauma was increased significantly. During the environmental protection in eastern Ukraine was recorded 243 cases. In 208 cases (85.6%) we identified satisfactory result, in 20 (8.2%)—the treatment resulted in amputation of lower extremities, in 11 (4.5%)—the treatment resulted in amputation of upper extremities, in four cases (1,7)—lethal. The purpose of the work was to analyze the results of treatment in a patient with a gunshot wound of the popliteal artery in the National Military Medical Clinical Center “Main Military Clinical Hospital” (NMCC) . Materials and Methods: the patient was admitted to the vascular surgery clinic with a diagnosis: Gunshot bullet penetrating wound of soft tissues of the left popliteal area (08.08.21.) with damage to the popliteal artery and vein, posterior tibial nerve, with complaints of severe pain in the left leg, swelling of the limb, wounds in the lower leg, general weakness. Treatment: first aid was provided at the scene: a tourniquet was applied to the hip. He was evacuated to the military hospital in Kurakhove, where permedPHO wounds, prothesis of the popliteal artery with PTFE, ligation of the popliteal vein, fasciotomy. 08.09.21 - evacuated to the NMCC , where were performed: Revision of the vascular bundle of the left leg, repeated surgery, removal of the long tibialis muscle, partial resection of a deep portion of the soleus muscle of the left leg (10.08.21.); Repeated surgical treatment of wounds (RSTW), partial resection of necrotic muscles of the left leg (12.08.21.); RSTW, removal of the anterior tibialis muscle, partial resection of necrotic muscles of the left leg (14.08.21.); RSTW, installation of VAC-system on wounds of the left leg (16–21.08.21.); Wound revision, refurbishment, secondary suturing of wounds (31.08.21.). Pictures 1–4. Condition of wounds during RSTW Pictures 5–6. Condition of wounds after healing. Results: The state of blood circulation of the lower extremities is compensated. The skin is pale pink, warm to the touch, sensitivity and motor function are preserved, pulsation is determined on the arteries of the feet, swelling of the left leg stiffness, wounds healed under the sutures, sutures removed. Conclusion: Gunshot wounds of the main vessels remain controversial and sophisticated area of vascular surgery. The main task for medical professionals for today is the creation of the clear algorithm of the effective medical assistance on the stage of medical evacuation directed at rescue of life from acute bleeding, saving of the extremity, treatment of complications and outcomes in time, foundation of the system of the specialized surgical assistance and rehabilitation. Publication History Article published online: 10 June 2022 © 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
Source: Aorta
Authors: Yuliia Nahaliuk, Volodymyr Rogovski, Victor Chernyak
Institution: Taras Shevchenko National University of Kyiv
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4285503071