[Surgical services in a central regional hospital in for ballistic wounds during the armed conflicts]

There was effectuated an analyze of delivery of health care to 1294 patients with ballistic wounds, admitted to Gudermess central regional hospital of Chechen Republic during the armed conflict on Northern Caucasus in 1994-2002. Age of wounded was between 12 and 67 years old, among them men - 1088 (84.1%), women - 206 (15.9%) and children - 291 (22.5%). Native population - 945 persons (73%), military servicemen from different departments - 349 persons (27%). In accord with character of destructive factor all wounds were divided in following way: ballistic wounds - 419 cases (32.4%), fragment wounds - 466 cases (36%), explosive wounds - 409 cases (31.6%). 392 persons (30.3%) had isolated wounds, 340 persons (26.3%) had multiple wounds, 513 persons (39.6%) had conjoined wounds, 49 persons (3.8%) had combined (term-mechanic) wounds. In accord with localization all wounds were divided in following way: head - 93 cases (7.2%), neck - 19 cases (1.5%), sternum - 117 cases (9%), stomach - 110 (8.5%), bowl - 89 cases (6.9%), axis - 21 cases (1.6%), upper limbs - 352 (27.2%), lower limbs - 493 cases (38.1%). 1074 were operated, term from admission to operation was: for emergency operation - 2.1+/-0.3 h, for delayed operations - 12+/-0.5 h. 220 patients were not operated, 6 of them died in 30-45 minutes after admission (cause - damages, not compatible with life). 214 were not pertained for first surgical aid. Postoperation complications were 8.2%, mortality - 2.6%, postoperation lethality - 1.93%, average term of stay in hospital - 24.3+/-0.3 days.