Characteristics of First Aid Types for Pelvic Trauma in Women Injured During Local Military Conflicts

   AIM OF STUDY. To assess the types and scope of first aid for pelvic injuries in women in conditions of local military conflict.

   MATERIAL AND METHODS. To achieve this goal, an analysis of injuries received during local military operations carried out in the Republic of Chechnya from 1991 to 2000 was carried out. The treatment was carried out on the basis of the surgical hospital of medical organization No. 9 in Grozny. The severity of the injury was determined retrospectively using the Field Surgery Scale, distinguishing four degrees of severity. Injured patients with combined injuries to the chest, abdomen, and head were excluded. The average age of patients was 34 [28; 40] years. The total number was 86.

   RESULTS. As the study shows, group A included 54 (62.8 %), and group B included 32 (37.2 %) patients. The distribution by group is presented as follows: in group A, 44 (51.2 %) shrapnel wounds, 10 (11.6 %) gunshot wounds. In group B, there were, respectively, 25 shrapnel (29.1 %) and 7 gunshot (8.1 %) wounds. Further analysis showed that penetrating wounds predominated, which were observed in 67 (77.9 %) cases, non-penetrating wounds were only revealed in 19 (22.1 %) cases (r = 0.97, p < 0.05, statistically significant). Distribution by groups: in group A there were 48 (55.8 %) and 6 (7.0 %), respectively, in group B there were 19 (22.1 %) and 13 (15.1 %) observations. Anti-shock measures, which include pain relief and infusion therapy, were carried out in 31 (36.0 %) cases in group A and in 5 (5.8 %) cases in group B (r = 0.97, p < 0 .05, statistically significant). At the same time, in the group of patients where first aid was provided by random witnesses or as self-help, the n

1. Chovanes J, Cannon JW, Nunez TC. The Evolution of Damage Control Surgery. Surg Clin North Am. 2012;92(4):859–875. PMID: 22850151 doi: 10.1016/j.suc.2012.04.002

2. Bel’skikh AN, Samokhvalov IM, Grebenyuk AN, Badalov VI, Kabanov MYu, Golovko KP, et al. Ukazaniya po voenno-polevoy khirurgii. Moscow: Glavnoe voenno-meditsinskoe upravlenie MO RF; 2013. (In Russ.) Available at: https://www.vmeda.org/wp-content/uploads/2016/pdf/ukazaniya_po_vph_2013.pdf [Accessed Nov 27, 2023]

3. Zhianu K, Baldan M, Molde A. Voenno-polevaya khirurgiya. Rabota khirurgov v usloviyakh ogranichennosti resursov vo vremya vooruzhennykh konfliktov i drugikh situatsiy nasiliya. In 2 vol. [Zheneva]; 2013. Vol. 2, Ch. 33: Povrezhdeniya mochepolovykh organov. pp. 527–551. Available at: https://www.icrc.org/ru/doc/assets/files/publications/war_surgery_vol2_rus.pdf [Accessed Nov 27, 2023]

4. Stefanopoulos PK, Mikros G, Pinialidis DE, Oikonomakis IN, Tsiatis NE, Janzon B. Wound ballistics of military rifle bullets: An update on controversial issues and associated misconceptions. J. Trauma Acute Care Surg. 2019;87(3):690–698. PMID: 30939579 doi: 10.1097/TA.0000000000002290

5. Global Burden of Disease 2016 Injury Collaborators; Naghavi M, Marczak LB, Kutz M, Shackelford KA, Arora M, Miller-Petrie M, et al. Global Mortality from Firearms, 1990–2016. JAMA. 2018;320(8):792–814. PMID: 30167700 doi: 10.1001/jama.2018.10060

6. Bukhsbaum TD. Travmy pri beremennosti. Moscow: Meditsina Publ.; 1982. (In Russ.)

7. Efimenko NA, Gumanenko EK, Samokhvalov IM, Trusov AA. Khirurgicheskaya pomoshch’ ranenym v vooruzhennom konflikte: problemy i puti sovershenstvovaniya. Military Medical Journal. 2000;321(2):31–35. (In Russ.)

8. Maslyakov VV, Salov IA, Sidelnikov SA, Uryadov SE, Parshin AV, Barsukov VG, et al. Optimization of Surgical Management of Pelvic Gunshot Wounds With Internal Genital Damage in Women. Polytrauma. 2023;(4):14–20. (In Russ.) –20. URL: https://poly-trauma.ru/index.php/pt/article/view/486/767

9. Gumanenko EK (ed). Voenno-polevaya khirurgiya. 2^nd ed., rev. and exp. Moscow: GEOTAR-Media Publ.; 2016. (In Russ.)

10. Masljakov VV, Chuprina AР, Kurkin КG. Improving the Provision of Surgical Care to the Civilian Population with Gunshot Wounds to the Chest in Conditions of Local Armed Conflict. Emergency Medical Care. 2021;22(1):70–75. (In Russ.) doi: 10.24884/2072-6716-2021-22-1-70-75