Vol.15, No 2, 2008 pp. 56 - 68
UC 616.717.7-089
TREATMENT OF THE WAR WOUNDS OF THE HAND
Jefta Kozarski, Srđan Cvetanović, Milomir Gačević, Svetlana
Vesanović
Clinic for Plastic Surgery and Burns, Military Medical Academy, Belgrade
E-mail: kozarski@eunet.rs
Summary. The significance of war injuries of the hand is the direct
consequence of the incidence of these wounds and the resulting disability.
According to the World War II data, the incidence of hand injuries is approximately
7% of all war injuries. Inadequate management and surgical treatment produce
severe disability. Due to highly specialized anatomic structure characterized
by a high ratio of skin surface and the volume of deeper tissue structures
and complex functional mechanisms it possesses, the hand is an organ the
injury of which requires specific diagnostic and surgical measures. Since
war injuries of the hand are mostly complex and associated with tissue
(cutaneous) defects, it is essential that a surgeon has good command of
the reconstruction methods in wound closure in the reparatory phase, as
well as of appropriate atraumatic technique in the reconstruction of tendons,
nerves, bones in the reconstruction phase. This paper aims at presenting
surgical management of war injuries of the hand according to the principles
of war surgery and to establish the place of plastic surgery in the management
of war injuries of the hand.
Key words: Hand, war wound,
surgery, treatment
TREATMAN RATNIH RANA ŠAKE
Kratak sadržaj: Značaj zbrinjavanja ratnih povreda šake proističe
iz njihove učestalosti i invaliditeta do kojih rane dovode. Prema podacima
iz II svetskog rata učestalost ratnih povreda šake iznosi oko 7% svih
ratnih povreda. Neadekvatno zbrinjavanje i hirurško lečenje dovodi do
teškog invaliditeta. Zbog visoko specijalizovane anatomske strukture koji
se karakteriše velikim odnosom površine kože u odnosu na zapreminu ostalih
dubokih tkivnih struktura i kompleksnog funkcionalnog mehanizma koje poseduje,
šaka predstavlja organ čije povrede zahtevaju specifične dijanostičke
i hiruške mere. Obzirom na činjenicu da su ratne povrede šake pretežno
kompleksne i praćene defektima tkiva (prvenstveno kože) od esencijalnog
značaja je da hirurg vlada rekonstruktivnim metodama zatvaranja rane u
reparatornoj fazi, kao i atraumatskom tehnikom tokom rekonstrukcije tetiva,
nerava i kosti u rekonstruktivnoj fazi. Cilj ovog rada je da se prikaže
hirurško zbrinjavanje ratnih povreda šake po principima ratno hirurške
doktrine i odredi mesto plastične hirurgije u zbrinjavanju ratnih povreda
šake.
Ključne reči: šaka, ratna
rana, hirurgija, tretman
