Keywords
combat injury
ultrasound guidance
soft tissue foreign bodies
How to Cite
Abstract
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Background. Gunshot wounds of the extremities remain one of the most common forms of combat trauma, accounting for more than 70% of cases. The presence of foreign bodies in soft tissues increases the risk of local infectious complications. Ultrasound examination demonstrates high sensitivity (97.9%), specificity ([85.0–95.0]%), and accuracy (>90.0%) in detecting foreign bodies.
Aim. To evaluate the effectiveness of ultrasound-guided removal of foreign bodies from the soft tissues of the extremities in patients with blind combat wounds.
Materials and Methods. The study included 100 patients with blind combat wounds of the soft tissues of the extremities. All patients underwent radiography in two projections and ultrasound examination of the injured area. In all cases, ultrasound was followed by surgical removal of foreign bodies with confirmation of their presence. To objectively assess wound healing dynamics, the Wound Healing Score (WHS) was used. Statistical analysis was performed using Epi Info 8.0 (CDC, USA).
Research Ethics. The study was conducted in accordance with the principles of the World Medical Association Declaration of Helsinki (1964–2024). All patients provided informed consent for treatment. The study design and methods were approved by the Ethics Committee of Kharkiv National Medical University (Protocol No.2 of October 12, 2022).
Results. The mean age of patients was 37 years. Ultrasound examination enabled identification of foreign bodies in 100.0% of patients, with successful removal achieved in 98.0% of cases. In most cases (75.0%), removal was performed through the wound tract without additional incisions; in 23.0% of cases, an additional surgical approach was required. Foreign bodies measuring up to 1 cm predominated (54.9%), with metallic fragments being the most common (70.9%). According to WHS, a statistically significant reduction in wound area and volume, decreased exudation, reduced incidence of necrosis, and active formation of granulation tissue with epithelialization as early as days [3–6] were observed (p<0.001).
Conclusions. The use of ultrasound guidance as part of a comprehensive diagnostic and therapeutic approach improves the accuracy of identification and removal of foreign bodies while minimizing tissue trauma.
Keywords: surgery, combat injury, ultrasound guidance, soft tissue foreign bodies.
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