Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego · 2026
Histomorphological changes in gunshot wounds using the developed method of surgical debridement of soft tissue defects in amputation stumps after gunshot traumatic amputations of lower extremities.
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Shaprynskyi Yevhen V, Lypkan Vasyl M, Karyi Yaroslav V, Makhovskyi Oleksandr L, Tomashevskyi Anatolii V
Аннотация
OBJECTIVE: Aim: To study histomorphological changes in gunshot wounds when applying the developed technique of surgical debridement of soft tissue defects in amputation stumps following gunshot traumatic amputations of the lower extremities.
PATIENTS AND METHODS: Materials and Methods: A histomorphological study of soft tissue defects in amputation stumps was carried out in 40 patients, including 20 patients in the main group who were treated according to the developed surgical debridement technique involving pulse lavage, ultrasonic cavitation, proposed dermatotension sutures, and early plastic closure. Tissue samples were obtained during hospitalization - on day 1; during the second debridement - on day 4; and during the fourth one - on day 12.
RESULTS: Results: On day 1, histomorphological changes were similar in the patients of both groups, presenting as deep defects, an extensive damage region with necrosis in the centre, diffuse polymorphonuclear inflammatory infiltration, and signs of oedema with marked perifocal inflammatory changes. On day 4, a decreased volume of necrotic tissue was noted in the patients of the main group as compared to the control group; the infiltrate contained segmented neutrophils in low quantities, and there was significant development of granulation tissue. On day 12, the patients of the main group showed complete resolution of the inflammatory process with healing of soft tissue defects and formation of a fully epithelialised connective tissue scar.
CONCLUSION: Conclusions: The histomorphological study of soft tissue defects in amputation stumps in patients treated by the developed surgical debridement technique demonstrated rapid elimination of necrotic tissue, a decrease in signs of inflammation, early development of mature granulation tissue, and wound healing.
PATIENTS AND METHODS: Materials and Methods: A histomorphological study of soft tissue defects in amputation stumps was carried out in 40 patients, including 20 patients in the main group who were treated according to the developed surgical debridement technique involving pulse lavage, ultrasonic cavitation, proposed dermatotension sutures, and early plastic closure. Tissue samples were obtained during hospitalization - on day 1; during the second debridement - on day 4; and during the fourth one - on day 12.
RESULTS: Results: On day 1, histomorphological changes were similar in the patients of both groups, presenting as deep defects, an extensive damage region with necrosis in the centre, diffuse polymorphonuclear inflammatory infiltration, and signs of oedema with marked perifocal inflammatory changes. On day 4, a decreased volume of necrotic tissue was noted in the patients of the main group as compared to the control group; the infiltrate contained segmented neutrophils in low quantities, and there was significant development of granulation tissue. On day 12, the patients of the main group showed complete resolution of the inflammatory process with healing of soft tissue defects and formation of a fully epithelialised connective tissue scar.
CONCLUSION: Conclusions: The histomorphological study of soft tissue defects in amputation stumps in patients treated by the developed surgical debridement technique demonstrated rapid elimination of necrotic tissue, a decrease in signs of inflammation, early development of mature granulation tissue, and wound healing.