Complex and Unresolved Issues in the Treatment of Wounded Patients During Wartime in Ukraine: The Concept of Early and Continuous Closure of Wounds and Soft Tissue Defects of the Limbs

Objective. To conduct a comprehensive analysis of the clinical efficacy of the concept of early and continuous wound closure in wartime based on our own experience in treating the wounded. Materials and Methods. A retrospective cohort study with elements of comparative analysis was conducted, including 146 patients (134 men and 12 women) aged 21 to 84 years, with a mean age of (34.7 ± 8.9) years, who were treated for combat-related soft tissue injuries between March 2022 and October 2025. All of these patients were treated according to the concept of early and continuous wound closure using negative pressure therapy and staged reconstructive procedures, and they constituted the main group. The control group consisted of 89 patients with similar injuries who were treated using standard methods without the concept of early and continuous wound closure between 2014 and 2021. Results. The time to final wound closure was 12.4 days in the experimental group and 24.8 days in the control group (p < 0.001). The incidence of infectious complications was 8.9%, compared to 28.7% in the control group (p < 0.001). Full functional recovery was achieved in 87.7% of patients, compared to 60–70% in the control group. The average number of surgical procedures per patient was 2.8 ± 1.1 (4.6 ± 1.8 in the control group), and the in-hospital mortality rate was 2.7% (7.9% in the control group). Conclusions. The application of the concept of early and continuous wound closure in wartime has yielded significantly better clinical outcomes than standard treatment methods, specifically a reduced incidence of complications, shorter treatment times, and improved rates of functional recovery.