S. S. Strafun, V. H. Shypunov, A. M. Laksha, N. O. Borzykh, Ya. V. Tsymbaliuk, N. M. Sydorova

ASSESSMENT OF SUBFASCIAL PRESSURE CHANGES IN INJURED WITH POLYSTRUCTURAL GUNSHOT WOUNDS TO THE LOWER EXTREMITY

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About the author:	S. S. Strafun, V. H. Shypunov, A. M. Laksha, N. O. Borzykh, Ya. V. Tsymbaliuk, N. M. Sydorova
Heading	CLINICAL MEDICINE
Type of article	Scentific article
Annotation	The purpose of the study was to study the changes in subfascial pressure in wounded with gunshot wounds to the lower extremity during the first 24 hours after injury. Data of 137 measurements of subfascial pressure in osteofascial compartments of the damaged segment, obtained in 128 servicemen with gunshot wounds, were analyzed. In gunshot fractures of the lower extremities, the average level of subfascial pressure increases in the period from 6 to 12 hours after injury by 35.8 % (p=0.0111) with a total rise for the first 24 hours after injury from 29.9±11.4 to 47.2±8.8 mm Hg (p=0.0005), but remains statistically similar for the periods 6–12 and 12–24 hours after injury. In cases with soft tissue gunshot wounds to the lower extremity, the average value of subfascial pressure progressively increases (after 6–12 hours from injury by 22.9 %, after 12–24 hours – by another 39.4 %, р=0.0240 and р=0.0076, respectively). Isolated tangential soft tissue gunshot wounds to the lower extremity without fascia lesion do not have any statistically significant effect on the subfascial pressure levels.
Tags	compartment syndrome,osteofascial compartments,fasciotomy,“rescue fasciotomy time interval” after injury
Bibliography	Zarutskyyi YaL, Bilyi VYa, redaktor. Voyenno-Poleva khirurhiya. Kyiv: Feniks; 2018. 552 p. [in Ukrainian] Zarutskyyi YaL, Shudrak AA, redaktor. Vkazivky z Voyenno-Polevoyi Khirurhiyi. Kyiv: SPD Chalchynska NV; 2014. 396 р. [in Ukrainian] Strafun SS, Laksha AM, Shypunov VH, Borzykh NO, Lozhkin IO. Pomylky ta uskladnennia diahnostyky ta likuvannia mistsevoho hipertenzyvnoho ishemichnoho syndromu pry vohnepalnykh ushkodzhenniakh nyzhnikh kintsivok. Travma. 2019; 20(4) :112–9. doi:10.22141/1608-1706.4.20.2019.178754. [in Ukrainian] Tsymbaliuk VI, redaktor. Vohnepalni poranennia miakykh tkanyn dosvid antyterorystychnoyi operatsii/operatsii obyednanykh syl. Kharkiv: Kolehium; 2020. 400 p. [in Ukrainian] Chaplyk V, redaktor. Nevidkladna viyskova khirurhiya. Kyiv: Nash Format; 2015. 568 p. [in Ukrainian] Cone J, Inaba K. Lower extremity compartment syndrome. Trauma Surgery & Acute Care Open. 2017; 2 :e000094. doi:10.1136/tsaco-2017-000094. Emergency war surgery (Borden Institute). Fourth United State Revision. US Army Medical Department Center and School Fort San Houston. Texas/Falls Church: Virginia; 2013. 568 р. Gordon WT, Talbot M, Shero JC, Osier CJ, Johnson AE, Balsamo LH, et al. Acute Extremity Compartment Syndrome and the Role of Fasciotomy in Extremity War Wounds. Military Medicine. 2018; 183 (2) :108–111. doi:10.1093/milmed/usy084. Sigamoney K, Khincha P, Badge R, Shah N. Compartment syndrome: challenges and solutions. Orthop Res Rev. 2015; 7:137–148. doi:10.2147/ORR.S50776. Zacharia B, Selvaraj RV. Acute Compartment Syndrome of the Extremities and Paraspinal Muscles. In: Sözen S, Kanat BH, editors. Trauma and Emergency Surgery [Internet]. London: IntechOpen; 2021 [cited 2022 May 18]. Available from: https://www.intechopen.com/chapters/77886 doi: 10.5772/intechopen.97841
Publication of the article	«World of Medicine and Biology» №3(81), 2022 year, 188-192 pages, index UDK 617.58-001.45-071
DOI	10.26724/2079-8334-2022-3-81-188-192