TREATMENT OF GUNSHOT PENETRATING WOUNDS OF THE CHEST IN A FIELD MOBILE HOSPITAL DURING COUNTER-TERRORIST OPERATIONS gvkg2024@mail.ru

 

TREATMENT OF GUNSHOT PENETRATING WOUNDS OF THE CHEST IN A FIELD MOBILE HOSPITAL DURING COUNTER-TERRORIST OPERATIONS

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Russia

Oral or Poster

In the 21st century the main cause of death in the terrorist attack zone and during the evacuation stages remains thoracic injuries.

Records of the terrorist attack casualties servicemen from 2000 to 2025 were reviewed.

Among those who died, chest wounds were detected in 95, of which: wounds to vital organs were in 38 (40%), fatal blood loss in 46 (48.4%), acute respiratory failure in 11 (11.6%). One in three of those who died were retrospectively classified as “potentially preventable deaths”. 253 servicemen were taken to a field hospital with gunshot penetrating thoracic wounds, 85% of them within 2 hours after the terrorist attack. There were isolated injuries in 13%, combined in 87%. Two areas of the body were damaged in 41.5%, three in 47.8%, four in 9.9%, five in 0.8%. AIS=4.1±0.4, ISS=28.1±1.3. All the wounded were urgently operated on. Thoracentesis and tubular thoracostomy was performed in 56.1%, emergency thoracotomy in 34.8%, open pneumothorax was sutured in 9.1%. During thoracotomy, atypical resection of the lungs (24), suturing of wounds of the lungs (48), heart (11), lobectomy (3), pneumonectomy (2) and stopping bleeding from the vessels of the mediastinum and chest wall were performed. After using damage control tactics for combined chest wounds (n=47), mortality decreased from 23.8% to 10.6%. The causes of death were damage to vital organs, massive blood loss, adult respiratory distress syndrome, sepsis.

Using damage control tactics made it possible to reduce the mortality rate for combined gunshot penetrating wounds of the chest to 10.6%.