[Combined gunshot penetrating chest wounds: current state of the problem (scoping review)]

Combined gunshot chest wounds are one of the most severe injuries, are associated with a high mortality, a high number of various complications, and require long-term treatment.

To study and summarize the treatment outcomes in patients with combined gunshot penetrating chest wounds in world practice during armed conflicts and in peacetime.

A literature search was conducted in the medical Internet search system PubMed and the e-library search system for the keywords "combat thoracic trauma," "combined gunshot chest wounds," "thoracoabdominal wounds," and "gunshot chest wounds" for the period from 1980 to 2025; also, Russian studies on the treatment of combined gunshot chest wounds were reviewed. The review included scientific papers addressing the epidemiology, evacuation, diagnosis, treatment, prevention, and expert evaluation of combined gunshot penetrating chest wounds.

The initial search identified 3.718 papers, of which 35 were eventually selected. Combined gunshot penetrating chest wounds account for 81.9% of all chest injuries; the mortality varies from 3 to 80%. Thoracoabdominal wounds receive much more attention compared to wounds of other sites due to their high prevalence (10-35%), severity, and mortality up to 59%. A high prevalence of explosive wounds in the armed conflicts of the 21^st century and the use of cluster munitions with an atypical trajectory of projectiles result in high relevance and social significance of not only thoracoabdominal wounds, but also combined wounds to the chest and limbs unprotected by armor plates, leading to the disability of military personnel.

The high mortality indicates the need to improve treatment and diagnostic approaches, develop new therapies for combined injuries of the chest, abdomen, and limbs, and find effective ways to evacuate the injured from the battlefield for medical care.