Plastic of soft tissue defects of the extremities resulting from combat injuries
DOI:
https://doi.org/10.32782/2415-8127.2025.71.5Keywords:
soft tissue defects, limbs, plastic defects, combat traumaAbstract
Introduction. Closure of tissue defects of any localization remains a difficult problem of reconstructive plastic surgery, especially in wartime conditions and the peculiarities of gunshot wounds. Among the large number of defect closure methods due to good aesthetic and functional results, skin-muscular flaps on feeding legs are more often used.Purpose. To improve the results of treatment of patients with extensive soft tissue defects resulting from mine-explosive injuries.Materials and methods. An analysis of the results of treatment of 68 patients with various types of soft tissue damage resulting from mine- explosive trauma (MVT), who were undergoing staged treatment in the surgical and traumatology departments of the VP “KLPL” KNP “UMBCL” UMR in 2024, was conducted. Preparation of patients for defect closure was carried out taking into account the phases of the wound process. The sural flap technique was used in 15 patients. Closure of soft tissue defects using the medial abdomen of m. gastrocnemius was used in seven patients. Using the lateral abdomen of m. gastrocnemius was used in three patients. In 32 patients, the skin-fascial local rotational flap technique was used to close soft tissue defects in different areas. In four cases, the thoraco-dorsal muscle flap was used. The Quaba flap (Dorsal metacarpeal artery perforal flap) method was used to close soft tissue defects of the main phalanx in three cases. A complication was observed in the group using the sural flap: in three cases, venous engorgement of the flap with partial necrosis was observed (20%), in one case, the flap completely necrotized (7%).Conclusion. All cases of complications recorded by us are associated with postischemic tissue changes and angiopathy, which are caused or induced by the prolonged use of tourniquets (more than 3-4 hours) at the stages of providing first aid in combat conditions. The used methods of plastic replacement of soft tissue defects are highly effective in treating the consequences of mine-explosive trauma.
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