PROGNOSTIC ASSESSMENT OF TISSUE PERFUSION IN WOUNDED PATIENTS WITH COMBAT-RELATED COMBINED COLD THERMOMECHANICAL INJURY USING DOPPLER ULTRASONOGRAPHY AND THERMOMETRY

Authors:

Abstract:

Combat extremity injuries combined with systemic hypothermia and local cold-induced tissue damage are associated with a high risk of regional ischemia and secondary necrosis, and early objective assessment of tissue viability remains a major clinical challenge. This study included 213 wounded service members with firearm fractures of the extremities accompanied by general hypothermia and local cold injury, in whom regional perfusion was evaluated using venous ultrasound assessment and infrared thermography. Severe impairment of venous outflow was strongly associated with the development of secondary necrosis and was accompanied by a more than threefold increase in relative risk. Venous hemodynamic parameters demonstrated high predictive accuracy and exceeded the prognostic value of temperature asymmetry. The combined use of ultrasound assessment and thermographic analysis improved risk stratification and enabled early identification of critically impaired tissue perfusion. These findings confirm the leading role of venous microcirculatory dysfunction in the progression of ischemic tissue damage and support the use of integrated perfusion assessment in early clinical decision-making.

Keywords:

combat surgical trauma frostbite firearm fracture osteosynthesis polytrauma

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Publication:

«World of Medicine and Biology» Vol. 22 No. 96 (2026) , с. 71-76
УДК 616–001.18/.19+616.71–001.5]–089–057.36:355

DOI:

https://doi.org/10.26724/2079-8334-2026-2-96-71-76