Authors
Pilnikov S.A.1, Vojnovskij A.E.2
1 Main military clinical hospital of the Russian national guard Troops, Balashikha
2 Sechenov University, Moscow
Abstract
The results of two methods of limb amputation for mine-explosive trauma in 199 wounded from 1995–2011 are considered. Limb amputations with stump suturing and wound drainage were performed in 98 patients in 1995–2001. Since 2002, 101 patients have used the method of preliminary limb amputation with histochemical identification of the degree of muscle tissue ischemia. Correctly performed pre-amputation with morphological assessment of the viability of the limb stump tissues allowed reducing the frequency of anaerobic infection from 19.4% to 10.9%, reducing the number of reamputations and reducing the mortality rate by half-from 15.3 to 6.9%. In the result of the analysis of the treatment of the wounded with mine-explosive trauma limbs it is concluded that the fundamental principle in emergency amputation of a limb should be considered a preliminary amputation of the limb using the diagnostic sections with histochemical identification of tissue ischemia to evaluate the viability of the limb tissue and bepcii muscle tissue for a rapid histological studies in wounded that contribute to the objectivization of the choice of technique and level of amputation and, thus, to reduce the frequency of early postoperative complications. Anaerobic infection in limb mine-explosive trauma with the absence of a clear manifested clinical picture occurs in 15.1% of wounded patients, which is the reason for late surgical treatment.
Keywords: limb, stump, mine-blast injury, amputation, reamputation, biopsy, anaerobic infection.
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