Treatment of gunshot wounds to spine at the stage of specialized medical care in mountainous desert areas

Abstract

PURPOSE OF RESEARCH. To improve the results of treatment of wounded with gunshot wounds of the spine and spinal cord at the stage of specialized medical care in mountainous desert areas.

MATERIAL AND METHODS. The analysis of treatment of 23 wounded with gunshot wounds of the spine and spinal cord, among which the syndrome of complete impairment of the spinal cord was revealed in 5 wounded (21.9%), the syndrome of partial impairment of conductivity — in 4 (17.2%) and without neurological deficit — 14 wounded (60.9%). All the wounded were carried out spondylography. In the acute period 20 were operated, in the early period — 3.

RESULTS AND DISCUSSION. Through the application of active flow-wash drainage using local hypothermia and epileptogenic of antibiotics was not a single case of complications from the gunshot wounds. In our observations, there were no cases of spinal instability after a gunshot wound, except for injuries to the cervical spine. Cases of significant improvement in the condition of the victims were noted in isolated injuries of the spine, accompanied by compression of the spinal cord. The mortality rate was 3.6%, which was associated with an increase in the frequency of concomitant injuries. Perioperative factors affecting the outcome of treatment in these conditions are discussed.

SUMMARY. In case of damage compression of the spinal cord and compensated condition of the wounded, primary surgical treatment of wounds should be performed in an emergency. In the case of combined injuries urgent surgery is indicated to eliminate the threat to life. The operation on the spine is performed only after the stabilization of the general condition of the wounded. The use of flow-washing drainage and antibiotic therapy contribute to the favorable flow of gunshot wounds to spine and spinal cord.