The role of regional lymphatic therapy in gunshot wounds of the extremities

Cases of gunshot wounds of the extremities are increasing every year in the Republic of Uzbekistan and other countries of the world. The urgency of this problem is justified by the high rates of death, purulent-septic complications, and disability, especially given the progress in the development of new types of weapons with greater penetrating power. The purpose of this study was to conduct experimental regional lymphatic treatment and use the results of the protocol to manage patients with isolated and combined gunshot wounds of the extremities. To achieve the goal of the study, 169 patients with gunshot wounds of the extremities were examined and divided into four main groups receiving lymphotherapy and control subgroups receiving standard treatment. In experimental studies, gunshot wounds of the extremities on the first day after injury are characterized by volumetric swelling of the intercellular space with the accumulation of microbes and deposition of fibrin, cellular dentin, and necrobiosis products in the lymph nodes. The use of regional lymphatic therapy in the experimental groups showed an active and rapid process of soft tissue regeneration in the traumatized area compared to that in the control group. Timely sorting and transportation of the wounded to specialized medical institutions contributed to the high effectiveness of surgical and therapeutic treatment methods in the first hours after the injury. The use of lymphotropic antibiotic therapy with cephalosporins or aminoglycosides and lymphatic stimulation showed positive dynamics of connective tissue remodelling, consistently high and long-term concentration of drugs in the lymph nodes, and low rates of infectious complications. The data obtained can be used in military medicine, emergency medicine, and surgery to improve protocols for managing patients with gunshot wounds of the extremities and the introduction of tactics aimed at preserving the functionality of regional tissues and preventing infectious complications.

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