scholarly journals SIZE AND STRUCTURE OF SANITARY LOSSES IN WARS OF MODERN LOCAL ARMED CONFLICTS IN GUNSHOT INJURIES OF THE ABDOMEN WITH DAMAGE TO THE COLON

2021 ◽  
pp. 47-51
Author(s):  
K. V. Gumeniuk ◽  
O. A. Lavrenchuk
Keyword(s):  
Clinical Features ◽  
World Literature ◽  
Gunshot Wounds ◽  
Armed Conflicts ◽  
Gunshot Injuries ◽  
Size And Structure

The purpose of the study is to analyze the sources of domestic and world literature with the study of the magnitude and structure of sanitary losses in wars and modern local armed conflicts with gunshot wounds to the abdomen with damage to the colon. To investigate sanitary losses at gunshot wounds of a colon. Conclusions. Sanitary losses in wars of local armed conflicts with gunshot wounds to the abdomen with damage to the colon remain high worldwide, despite individual means of protecting the torso. In this regard, it is notable to further study the anatomical and clinical features of gunshot wounds of the colon in the experience of the antiterrorist operation in eastern Ukraine.

Surgical Treatment of Gunshot Injuries to the Mandible

2003 ◽  
Vol 129 (3) ◽  
pp. 239-244 ◽  
Author(s):  
Shawn D. Newlands ◽  
Sreedhar Samudrala ◽  
W. Kevin Katzenmeyer
Keyword(s):  
Risk Factors ◽  
Tertiary Care ◽  
Gunshot Wounds ◽  
Reconstructive Procedures ◽  
Gunshot Injuries ◽  
Mandibular Injuries ◽  
Severity Of Injury ◽  
Tertiary Care Centers ◽  
Mandible Fractures ◽  
Very High

OBJECTIVES: Our goal was to review and identify risk factors for complications from treatment of mandible fractures due to gunshot wounds. STUDY DESIGN AND SETTING: We conducted a retrospective review of treatment outcomes in 90 patients with gunshot wounds to the mandible treated over a 10-year period at 2 tertiary care centers. RESULTS: Our series of 90 patients with mandibular injuries due to gunshot wounds included 68 patients who underwent surgical procedures on the mandible. There were 14 complications in this group. Complications were more common in patients whose mandibles were rigidly fixated; however, these patients' injuries were more severe. Complications were significantly increased in patients who lost a segment of mandible in the injury. CONCLUSIONS: Complications were related to severity of injury and independent of treatment modality. SIGNIFICANCE: The complication rate for patients with gunshot injuries can be very high, particularly if bone is missing. Stabilization of remaining mandibular segments with potentially multiple subsequent reconstructive procedures is often required to restore mandibular continuity in these patients.

scholarly journals Features of the national development of possibilities forensic diagnostics of the gunshot injuries

2021 ◽  
pp. 3-10
Author(s):  
Yuliia Zmiievska ◽  
Ivan Savka
Keyword(s):  
Forensic Medicine ◽  
Three Dimensional ◽  
National Development ◽  
Gunshot Wounds ◽  
Medical Diagnostics ◽  
Diagnostic Methods ◽  
Gunshot Injuries ◽  
Spatial Reconstruction ◽  
Literary Sources ◽  
Forensic Scientists

This article shows the role and contribution of individual forensic scientists and famous forensic academies in the development of learning gunshot injuries. The article presents an analysis of the national literary sources concerning development of possibilities and methods of forensic diagnostics of the main traumatic factor of gunshot injuries. The role of up-to-date digital technologies, particularly the method of three-dimensional spatial reconstruction of the gunshot wounds, which can empower possibilities of forensic diagnostics of the main traumatic factor of gunshot injuries are shown. Aim of the work. To analyze the development of diagnostic methods of a kind of the main traumatic factor of gunshot injuries in forensic medicine, to find the up-to-date and most diagnostically valuable methods for further investigation and implementation into experts’ practical work. Conclusions. Analysis of national forensic experts’ studies shows that forensic medical examination of gunshot body wounds has always been of current interest and become more and more actual. In every period of forensic medicine development new instrumental and laboratory methods of examination of gunshot wounds have appeared. One of the most topical and promising methods are means of the three-dimensional spatial reconstruction. It can improve the possibilities of forensic medical diagnostics of a kind and characteristic of the main traumatic factor of gunshot wounds.

scholarly journals Civilian Gunshot Wounds to The Head: A Case Report, Clinical Management, and Literature Review.

2020 ◽  
Author(s):  
Haoyi Qi
Keyword(s):  
Clinical Management ◽  
Occipital Lobe ◽  
Gunshot Wounds ◽  
Complete Recovery ◽  
Management Evaluation ◽  
Gunshot Injuries ◽  
Short Period ◽  
Case Presentations ◽  
The Right ◽  
Short Time

Abstract Background: Civilian Gunshot wounds to the head refers to the brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives, gunpowder, etc. as a power launch or explosion. Gunshot wounds to the head is the deadliest of all gun injuries, according to literature statistics, the survival rate is only 9%.1 Due to the strict management of various types of firearms, they rarely occur, so the injury mechanism, injury and trauma analysis, clinical management, and surgical standards are almost based on military experience, and there are few related reports especially the head suffered a fatal blow more than once in a short time. We report a case with a return to almost complete recovery despite the patient suffered shots on the head twice in a short period of time.Case Presentations: We present a case of a 53-year old male who suffered twice gunshot injuries to the head under unknown circumstances. On initial presentation the patient had a Glasgow Coma Score of 6, unable to communicate, loss of consciousness. The first bullet penetrated from the right frontal area and finally reached the right occipital lobe. When the patient subconsciously covers his head with his hand, the second bullet through the patient's right palm bone, entered from the right frontotemporal, and stayed deep in the lateral sulcus. The patient had a cerebral hernia when he was admitted to the hospital, and immediately entered the operating room for rescue after a compute tomography scan. After two foreign body removals and one skull repair, the patient recovered completely.Conclusions: Gunshot wounds to the head have a high mortality rate and usually require aggressive management. Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital followed by proactive treatment against infection, seizure and increased intracranial pressure. Surgical intervention is usually necessary, and its key point usually includes the timing of the operation, the method of operation, and the scope of the operation.

High-Velocity Gunshot Wounds to the Head and Neck: A Review of Wound Ballistics

1998 ◽  
Vol 163 (5) ◽  
pp. 346-351 ◽  
Author(s):  
Sertac Yetiser ◽  
Mustafa Kahramanyol
Keyword(s):  
Head And Neck ◽  
Tissue Damage ◽  
High Velocity ◽  
Gunshot Wounds ◽  
Wound Ballistics ◽  
Firearm Injuries ◽  
Gunshot Injuries ◽  
Exit Wound ◽  
Life Threatening ◽  
Distinct Features

Abstract Patients who sustain gunshot injuries to the head and neck face heavy tissue damage and eventually life-threatening conditions. A very significant factor that determines the degree of injury is the course and extent of the missile track. The missile track is well correlated with bullet structure, size, and velocity, which have distinct features in civilian and military firearm injuries. The missile entrance or exit wound may be out of sight in some injuries, and often it is difficult to predict the severity of the injury in the chaotic circumstances of the battlefield. We studied the wound ballistics in five soldiers who suffered penetrating cranial and cervical firearm injuries.

scholarly journals THE APPLICATION OF BIOLOGICAL TISSUE SIMULATOR TO DIAGNOSE PERFORATING GUNSHOT WOUNDS CAUSED BY 5.45 mm CALIBER BULLETS

2016 ◽  
Vol 15 ◽  
pp. 404-414
Author(s):  
Y. N. Kravchenko ◽  
V. V. Sapelkin ◽  
I. Y. Serbinenko ◽  
A. V. Kolomijtsev
Keyword(s):  
Kinetic Energy ◽  
Biological Tissue ◽  
Gunshot Wounds ◽  
Biological Tissues ◽  
Resistance Coefficient ◽  
Unstable Behavior ◽  
Gunshot Injuries ◽  
Before And After ◽  
Ballistic Properties ◽  
Made In

The study and diagnosis of perforating gunshot wounds, especially those that are caused by 5.45 mm caliber bullets are connected with certain difficulties due to the instable behavior of these bullets in biological tissues (viscoelastic environment). With regard to that and based on the natural tests with the help of ballistic plasticine, the article establishes the peculiarities of perforating gunshot injuries caused by the abovementioned bullets. The natural tests also allowed to determine the influence of the changes made in the bullet structure in order to increase its expansion properties. In addition, the experiments determined the amount of kinetic energy of 5.45 mm bullets in order to perforate a block of ballistic plasticine of the respective width, it allowed to determine the resistance coefficient of the viscoelastic environment with regard to the unstable behavior of the bullet inside the obstacle. The article suggests a method to determine the speed of the bullet after it leaves the obstacle in the form of a simulator of biological tissues, it allows to determine the ballistic properties of 5.45 mm bullets before and after its contact with the obstacle.

FEATURES OF CLINICAL MANIFESTATIONS OF POST-TRAUMATIC NEUROPATHIES AND PLEXOPATHIES RESULTED FROM GUNSHOT AND NON-GUNSHOT INJURIES OF EXTREMITIES

2020 ◽  
pp. 45-48
Author(s):  
O. M. Borodai ◽  
Yu. V. Kas
Keyword(s):  
Nervous System ◽  
Peripheral Nerve ◽  
Peripheral Nervous System ◽  
Clinical Picture ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Gunshot Wounds ◽  
Armed Conflicts ◽  
Clinical Diagnoses ◽  
Post Traumatic

The number of traumatic injuries to nerve stems and plexuses is steadily increasing in peacetime during armed conflicts and terrorist acts. In wartime, peripheral nerve injuries are much more common, and a great deal of the knowledge about peripheral nerve damage and repair is based on combat experience. The study of the clinical course of post−traumatic neuropathies and plexopathies contributes to the development of clinical and neurological criteria and compensatory−restorative responses in traumatic lesions of the peripheral nervous system, helps to assess the functional significance of various parts of the nervous system when compensating a damaged functional unit. To study the features of clinical manifestations of post−traumatic gunshot and non−gunshot neuropathies and plexopathies, 63 patients underwent clinical and neurological examination with topical and clinical diagnoses, collection of detailed anamnesis and complaints, electroneuromyography and ultrasound examination. Movement disorders, characterized by peripheral paresis or plegia of the corresponding muscle group and accompanied with a reduced or lost tendon and periosteal reflexes, were common. Sensitivity disorders were a combination of prolapse (anesthesia, hypoesthesia) and irritation (paresthesia, hyperpathy, hyperesthesia). Autonomic disorders (vascular, secretory and trophic) in traumatic neuropathies differ depending on the clinical individuality of peripheral nerves. Vascular disorders were more often detected with partial damage to nerve structures and were accompanied by local edema. Of the secretory disorders, the most constant sign of impaired nerve conduction was sweating disorder. In the clinical picture of the pain syndrome, i.e. causalgia, the pain sensations by type of burning dominated. The intensity of the pain syndrome in severe cases was very high, in some cases the pain was exacerbated by irritation of the senses. The clinical picture of causalgia is characterized by an increased pain when warming the injured limb and it reduced when cooled, that is a "symptom of a wet rag." Knowledge of clinical features allows the detection of the peripheral nervous system lesions at the early stages of pathology, performance of dynamic clinical and neurological observation and treatment, timely use of modern additional research methods to address further treatment tactics that restore limb function, improve quality of life. Key words: post−traumatic neuropathy and plexopathy, peripheral nervous system, gunshot wounds of nerves and plexuses.

scholarly journals Penetrating injuries in Germany – epidemiology, management and outcome an analysis based on the TraumaRegister DGU®

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
D Bieler ◽  
E Kollig ◽  
L Hackenberg ◽  
JH Rathjen ◽  
R Lefering ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Violent Crime ◽  
Gunshot Wounds ◽  
Haemorrhagic Shock ◽  
Trauma Centre ◽  
Penetrating Injuries ◽  
Stab Wounds ◽  
Gunshot Injuries ◽  
Trauma Society ◽  
Low Incidence

Abstract Background The management of penetrating wounds is a rare challenge for trauma surgeons in Germany and Central Europe as a result of the low incidence of this type of trauma. In Germany, penetrating injuries are reported to occur in 4–5 % of the severely injured patients who are enrolled in the TraumaRegister DGU® (trauma registry of the German Trauma Society). They include gunshot injuries, knife stab injuries, which are far more common, and penetrating injuries of other origin, for example trauma caused by accidents. The objective of this study was to assess the epidemiology and outcome of penetrating injuries in Germany, with a particular focus on the level of care provided by the treating trauma centre to gain more understanding of this trauma mechanism and to anticipate the necessary steps in the initial treatment. Materials and methods Since 2009, the TraumaRegister DGU® has been used to assess not only whether a trauma was penetrating but also whether it was caused by gunshot or stabbing. Data were taken from the standard documentation forms that participating German hospitals completed between 2009 and 2018. Excluded were patients with a maximum abbreviated injury scale (MAIS) score of 1 with a view to obtaining a realistic idea of this injury entity, which is rare in Germany. Results From 2009 to 2018, there were 1123 patients with gunshot wounds, corresponding to a prevalence rate of 0.5 %, and 4333 patients with stab wounds (1.8 %), which were frequently caused by violent crime. The high proportion of intentionally self-inflicted gunshot wounds to the head resulted in a cumulative mortality rate of 41 % for gunshot injuries. Stab wounds were associated with a lower mortality rate (6.8 %). Every fourth to fifth patient with a gunshot or stab wound presented with haemorrhagic shock, which is a problem that is seen during both the prehospital and the inhospital phase of patient management. Of the patients with penetrating injuries, 18.3 % required transfusions. This percentage was more than two times higher than that of the basic group of patients of the TraumaRegister DGU®, which consists of patients with a MAIS ≥ 3 and patients with a MAIS of 2 who died or were treated on the intensive care unit. Conclusions In Germany, gunshot and stab wounds have a low incidence and are mostly caused by violent crime or attempted suicides. Depending on the site of injury, they have a high mortality and are often associated with major haemorrhage. As a result of the low incidence of these types of trauma, further data and analyses are required in order to provide the basis for evaluating the long-term quality of the management of patients with stab or gunshot wounds.

scholarly journals СТВОРЕННЯ КОНЦЕПЦІЇ ТЕРМОГРАФІЧНОЇ КЛАСИФІКАЦІЇ ВОГНЕПАЛЬНИХ ПОРАНЕНЬ М’ЯКИХ ТКАНИН

World Science ◽  
2020 ◽  
Vol 1 (4(56)) ◽  
pp. 32-36
Author(s):  
І. П. Хоменко ◽  
К. В. Гуменюк ◽  
Є. В. Цема ◽  
С. В. Тертишний
Keyword(s):  
Soft Tissues ◽  
Gunshot Wounds ◽  
Anatomical Structure ◽  
Multimodal Approach ◽  
Reconstruction Scheme ◽  
Gunshot Injuries ◽  
Main Basis

The aim. To study the effectiveness of using dynamic digital thermography in wounded with gunshot injuries of soft tissues in a multimodal reconstruction scheme. Based on the materials received, propose the concept of thermographic classification of gunshot wounds of soft tissues. Conclusions. The use of a multimodal approach in the reconstructive treatment of gunshot wounds of soft tissues is an effective method of repairing a damaged anatomical structure. The integration of the information obtained during the DDT is the main basis for the materialization of the conceptual creation of thermographic classification of gunshot wounds of soft tissues.

scholarly journals Gunshot wounds to the chest and abdomen when using modern body armor

2020 ◽  
Vol 22 (2) ◽  
pp. 115-121
Author(s):  
A. V. Denisov ◽  
P. E. Krainyukov ◽  
S. M. Logatkin ◽  
A. B. Yudin ◽  
V. V. Kokorin ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Experimental Studies ◽  
Gunshot Wounds ◽  
The Body ◽  
Armed Conflicts ◽  
Body Armor ◽  
Internal Organs ◽  
Abdominal Bleeding ◽  
Literary Sources ◽  
Bulletproof Vest

Based on the analysis of literary sources and the data of our own experimental studies, we examined the features of gunshot wounds of military personnel protected by body armor. The classification of body armor by design is given. In addition, the gradation of body armor according to the protection class according to GOST 34286-2017 is given. It is shown that the widespread use of body armor in modern armed conflicts has led to a noticeable decrease in the frequency of gunshot wounds to the chest. According to the mechanism of the formation of a gunshot injury through a bulletproof vest, three main types of injuries were identified: closed local contusion injury when the bulletproof vest was not broken; a gunshot wound when piercing a bulletproof vest; gunshot wounds due to ricocheting of striking elements from the surface of the body armor (external or internal ricochet). It has been established that closed trauma in case of bulletproof vest penetration can occur both in the form of damage to the skin and subcutaneous tissue with the formation of hemorrhages, and in the form of bruises of internal organs, accompanied in severe cases by ruptures of internal organs (liver, spleen, lungs, etc.), with development life- threatening complications - intense pneumothorax, intra-abdominal bleeding, etc. It is shown that when piercing a bulletproof vest through the wound, in addition to a deformed bullet and clothing elements, fragments of armor can be introduced lei with additional damage. When bullets approach a bulletproof vest at angles of 20 degrees or more, rebound elements of dismantled bullets can occur, which can cause severe damage to both the owner of the bulletproof vest and others.

scholarly journals Civilian gunshot wounds to the head: a case report, clinical management, and literature review

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Haoyi Qi ◽  
Kunzheng Li
Keyword(s):  
Clinical Management ◽  
Occipital Lobe ◽  
Gunshot Wounds ◽  
Complete Recovery ◽  
Management Evaluation ◽  
Gunshot Injuries ◽  
Short Period ◽  
Case Presentations ◽  
The Right ◽  
Short Time

Abstract Background Civilian gunshot wounds to the head refer to brain injury caused by projectiles such as gun projectiles and various fragments generated by explosives in a power launch or explosion. Gunshot wounds to the head are the deadliest of all gun injuries. According to literature statistics, the survival rate of patients with gunshot wounds to the head is only 9%. Due to the strict management of various types of firearms, they rarely occur, so the injury mechanism, injury and trauma analysis, clinical management, and surgical standards are almost entirely based on military experience, and there are few related reports, especially of the head, in which an individual suffered a fatal blow more than once in a short time. We report a case with a return to almost complete recovery despite the patient suffering two gunshot injuries to the head in a short period of time. Case presentations We present a case of a 53-year-old man who suffered two gunshot injuries to the head under unknown circumstances. On initial presentation, the patient had a Glasgow Coma Scale score of 6, was unable to communicate, and had loss of consciousness. The first bullet penetrated the right frontal area and finally reached the right occipital lobe. When the patient reflexively shielded his head with his hand, the second bullet passed through the patient’s right palm bone, entered the right frontotemporal area, and came to rest deep in the lateral sulcus. The patient had a cerebral hernia when he was admitted to the hospital and immediately entered the operating room for rescue after a computed tomography scan. After two foreign body removals and skull repair, the patient recovered completely. Conclusions Gunshot wounds to the head have a high mortality rate and usually require aggressive management. Evaluation of most gunshot injuries requires extremely fast imaging examination upon arrival at the hospital, followed by proactive treatment against infection, seizure, and increased intracranial pressure. Surgical intervention is usually necessary, and its key points include the timing, method, and scope of the operation.

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