Purulent complications of lower limb amputations due to mine blast trauma

Pilnikov S.A.^{1, 3}, Voinovsky A.E.², Brizhan L.K.^{2, 3}, Putintsev S.P.¹

The article presents the analysis of the occurrence of purulent-septic complications of amputation stumps of the lower limbs in casualties with mine blast injury (MBI) in contemporary armed conflicts and the principles of surgical treatment (amputation) of combat injuries of the lower extremities. The number of purulent complications of lower limb amputations due to MW in the last years does not decrease and was detected in 32,5% of affected and conditioned by irrational choice of primary amputation with the imposition of the primary seams on the wound of the stump, a violation of the technology of its execution, the presence of nosocomial infection and severe endogenous intoxication, impaired lymph drainage and tissue hypoxia stump, irrational management of patients in the postoperative period.

Aim: To assess the nature and frequency of purulent complications of amputation stumps in patients with lower limb MBI. Compare the results of the different types of standard amputations and amputations “according to the type of Primed surgery treatment (PST)”.

Materials and methods: An analysis was made of the identification and treatment results of perverse stumps and their diseases in 191 patients who underwent amputations of the lower extremities at different levels. 208 amputations of the lower extremities were performed (17 of the lower limbs were amputated by the wounded) over a 17-year period (1995–2011) at the Main Military Clinical Hospital of the Ministry of Internal Affairs of Russia.

We have studied the results of the treatment of 91 victims over a 6-year period (1999–2005 — stage I of the study), which after limb amputation, primary stitches were applied to the stump; developed by surgical tactics for certain types of amputations and re-­amputations, and preliminary limb amputation was applied in the subsequent 7-year period (2006–2012 — stage II of the study) in 100 wounded, due to mine-blasting wounds at the stages of medical evacuation and in the Main Military Clinical Hospital of the Ministry of Internal Affairs of Russia.

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