Хирургия современной боевой травмы груди

Аннотация

The article presents an overall estimate of experience of surgical treatment of ballistic penetrating wounds of bosom of 1920 wounded in Afgan war (1979-1989) and 367 wounded during the armed conflict on Northern Caucasus (1994-1996). Ballistic penetrating wounds of bosom in modern military conflicts are characterized by high mortality on battle field, achieving 30%. In conditions of heavy wound the choice of optimum surgery tactics poses several difficulties, and due to it indications urgent thoracotomy are often increased. Multistage system of delivery of health care, used in Afgan war, during battle actions on the Northern Caucasus was changed to 2-stage system, where wounded persons during 1-2 hours were delivered to a specialist in multiprofile base hospital, placed in a combat zone. Effectuating of thoracocentesis with a closed drainage of pleural space stays the most popular and extended method of treatment ballistic penetrating wounds of bosom, used by 85% of wounded persons. Using of operative videothoracoscopia in 1995 during delivery of emergency specialized surgical medical care to wounded persons in forward base hospital leaded to decreasing of frequency of using of large thoracotomy to 2,4%. There was overviewed the modern conception of surgical treatment of patients, having bosom wounds.