Types of Surgical Interventions Performed for Various Neck Injuries in Civilian Medical Facilities in the Context of a Localized Military Conflict

Relevance. Despite a sufficiently large number of works, the number of patients with neck wounds does not decrease due to unfavorable criminal situation and the presence of localized military conflicts. The Aim of the Study. To analyze the main types of surgical interventions performed for various neck wounds in a civilian medical institution in the conditions of localized military conflicts. Materials and Methods. The study is based on a retrospective analysis of the treatment of 214 patients with various neck injuries who were treated at the surgical ward of City Hospital № 9 in Grozny, Chechnya, from 1991 to 2000. All patients were divided into two groups: 129 were in the group with gunshot wounds and 112 were in the group with stab wounds to the neck. The mean age was 35 ± 5 years, with males predominating (78%). Results. It was found that in 25 (19,3%) cases, operations were performed under local anesthesia, and in 45% of this number anesthesia was given. When anesthesia was performed, in the majority of cases - 84% - there was tracheal intubation, in the rest - intravenous anesthesia was used. The main types of operations performed on the wounded in the neck were typical tracheostomy without laryngeal and tracheal suture in 26,3%; atypical tracheostomy without laryngeal and tracheal suture in 16,2%; laryngeal and tracheal suture with tracheostomy in 13,1%; and diagnostic revision of the internal structures of the neck, which was performed in 12,4% of cases. In addition, thoracotomy was performed in 10.8% of observations, in which, most often, suturing of esophageal wounds was performed. Conclusion. The conducted study confirmed the list of the main types of operations that surgeons resort to in the treatment of patients with gunshot wounds to the neck, admitted to a medical institution in an emergency in the conditions of a localized military conflict. Those operations include typical tracheostomy without laryngeal and tracheal suture; atypical tracheostomy without laryngeal and tracheal suture; laryngeal or tracheal suture with tracheostomy; and diagnostic revision of the internal structures of the neck.