Vol.7, No 1, 2000 pp. 91 -96
UC 612.82
CLINICAL EXPERIENCE IN MANAGEMENT OF WAR
INJURIES
CAUSED BY ARMAMENT DURING THE NATO AGGRESSION
Milan Višnjić, Aleksandar Petković, Nebojša Djenić, Predrag Kovačević
Clinic of Surgery, Clinical Center, Niš
Department of Surgery, Military Hospital, Niš, Yugoslavia
Summary. We present 109 wounded treated at the Department of Surgery
in Military Hospital Nis during the NATO aggression on FR Yugoslavia. All
the patients were male, 19 to 45 years old. Primary surgical wound management,
management of injured blood vessels, external fixation of bones, management
of injured inner organs were done on terrain by surgeons from Military
Hospital-Nis, and by surgeons from regional medical centers. All patients,
after primary surgical wound management and resuscitation, are directed
to Military Hospital Nis for the continuation of surgical treatment.
Explosive weapons (mines, bombs and cluster bombs) caused 58.7% injuries
and 41.3% of injuries are caused by firearms. Solitary injuries are represented
in 71.5% and simultaneous injuries in 24.5 %. Injuries of extremities
(in solitary injuries and simultaneous injuries) have the highest incidence
85.4%. Injuries of inner organs (solitary or simultaneous) and CNS are
relatively rare (13.7%)
We directed 23.8% of the wounded to Medical Military Academy, because
of the complexity of injuries and needs for long term and specific intensive
care.
Delayed primary wound closure and reconstruction were done in 75.9%;
secondary wound closure or reconstruction in 19.2% and amputations in 3.6%
of the wounded. Secondary reconstruction was indicated in 3.6% of the wounded
(leg bony defects and ulnar nerve repair). In 8.4% of the patients complications
were found: infection, flap necrosis and stress duodenal ulcer. Lethal
exits are not found.
Key words: War wounds, surgery, weapons
KLINIČKA ISKUSTVA U ZBRINJAVANJU RATNIH
POVREDA
VATRENIM ORUŽJEM U TOKU "NATO" AGRESIJE
Kratak sadržaj: Prikazana je grupa od 109 ranjenika lečenih u
Vojnoj bolinici Niš tokom Nato agresije na Jugoslaviju. Svi povređeni su
bili muškog pola starosti 19-45 godina. Primarna hirurška obrada rane,
potom zbrinjavanje povreda unutrašnjih organa, fiksacija polomljenih kostiju
i rekonstrukcija magistralnih krvnih sudova je rađena na terenu (na mestu
povrede) od strane hirurških ekipa vojne bolnice ili hirurških ekipa regionalnih
bolnica. Nakon reanimacije upućivani su u Vojnu bolnicu Niš radi daljeg
praćenja i daljeg hirurškog tretmana.
Eksplozivno oružje (mine, avio bombe, kasetne bombe) je bilo uzrok
povređivanja u 58,7% a ostale povrede (41,3%) su bile prouzrokovane steljačkim
naoružanjem.
Izolovane povrede pojedinih organa ili delova tela su bile dominantne
(71,5%) dok su udružene povrede verifikovane u 24,5 % povređenih. Povrede
ekstremiteta, izolovane ili udružene sa drugim povredama su bile daleko
najbrojnije (85,4%), dok su povrede unutrašnjih organa i CNS znatno ređe
(13.7%).
U prikazanoj seriji 23,8% povređenih je premešteno u zdravstvenu ustanovu
sa većim mogućnostima medicinsko sanitetske pomoći, a 76,1% je lečeno i
izlečeno u Vojnoj bolnici Niš. U toj grupi je primarno odloženi šav
ili rekonstrukcija rađena u 75,9% povređenih, sekundarni šav ili rekonstrukcija
u 19,2% a amputacija u 3,6% povređenih. Kod 3,6% povređenih je indikovana
naknadna rekonstrukcija ( kostiju ili živca) nakon zarastanja rane. Komplikacije
su registrovane kod samo 8,4% povređenih (infekcija, nekroza režnja , stres
ulkus) a smrtnih slučajeva nije bilo.
Ključne reči: Ratne rane, hirurško zbrinjavanje, oružje
