Polski Merkuriusz Lekarski最新文献

{"title":"Protection of the right to human dignity in medical relations in the practice of the European Court of Human Rights.","authors":"Oleksandr M Shevchuk, Svitlana V Davydenko, Iryna V Borodina, Oleksandr I Berezhnyi","doi":"10.36740/Merkur202601109","DOIUrl":"https://doi.org/10.36740/Merkur202601109","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To investigate the negative and positive obligations of the state in ensuring the right of an individual to respect for human dignity in medical and legal relations, taking into account the practice of the European Court of Human Rights, and to reveal the protection of this right among drug addicts.</p><p><strong>Patients and methods: </strong>Materials and Methods: The research methodology involves the analysis of national regulatory provisions, international treaties, legislative acts of Ukraine, and legal positions of the ECHR on the problems of implementing the right to respect for human dignity in medical and legal relations, as well as the case law of the European Court of Human Rights. Data analysis was conducted using open sources, mainly for the period 2010-2025. The main search keywords were \"ECHR\", \"protection of rights\", \"health care\", \"legal regulation\", \"the right of an individual to respect for human dignity\". The search criteria focused on modern scientific approaches and practical experience in ensuring the right of individuals to respect for human dignity in medical and legal relations. Sources that do not focus on medical-legal relations, that do not take into account the current practice of the ECHR, that do not comply with international human rights standards, legal acts or regulatory documents that contradict the practice of the ECHR were excluded from consideration.</p><p><strong>Conclusion: </strong>Conclusions: The study highlights cases of failure to fulfill negative obligations of a material nature of the studied right of individuals, among which the following are identified: improper performance by officials of their duties due to inaction (failure to provide medical services, which led to serious consequences); improper performance of official duties by officials of state bodies, as well as unlawful actions of law enforcement agencies of a deliberate nature (physical and psychological violence against persons in custody). An approach is proposed in which adherence to the principle of the supremacy of the law under study, taking into account the practice of the European Court of Human Rights, is the basis for respecting human rights and freedoms.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 1","pages":"60-65"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selective metabolic and hepatic biochemical alterations in breast cancer patients receiving different treatment protocols: A comparative cross-sectional study.","authors":"Ahmed M Amshawee, Maggie E Amer, Mena Mahfouz, Sherif Refaat, Khaled Abdelwahab, Mohamed E Abdraboh","doi":"10.36740/Merkur202603101","DOIUrl":"https://doi.org/10.36740/Merkur202603101","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To study biochemical changes in women with breast cancer according to treatment protocols, with emphasis on liver and metabolic markers.</p><p><strong>Patients and methods: </strong>Materials and Methods: A descriptive comparative cross-sectional study of 141 women including chemotherapy only (n=50), newly diagnosed n=46 and chemotherapy + metformin n=45 was conducted. The glucose, albumin, ALP, AST, ALT, creatinine and total bilirubin were determined in venous samples of blood by standard enzymatic methods. Data were presented as mean±SD and analyzed with one-way ANOVA.</p><p><strong>Results: </strong>Results: Glucose and ALP levels were significantly different. Compared with chemotherapy-only (86.38±15.96 mg/dL) and newly diagnosed groups, increased glucose (197.15±58.15 mg/dL) in the chemotherapy + metformin group p<0.001. Higher ALP was also noted in the metformin group (127.35±58.88 U/L) compared with chemotherapy alone (105.02±30.96 U/L) and newly diagnosed patients (108.81±40.84 U/L), p=0.039. Albumin, AST, ALT, creatinine and total bilirubin were not statistically different. AST was moderately correlated with ALT (r=0.524) and strongly correlated with total bilirubin r=0.752, p<0.001.</p><p><strong>Conclusion: </strong>Conclusions: The consumption of breast cancer therapy caused metabolic changes especially on glucose and ALP. Normal biochemical markers are still useful in surveillance for metabolic derangements due to treatment.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 3","pages":"251-258"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring system for practical skills of the future gnathologist: Criteria and descriptors.","authors":"Natalia V Stuchynska, Pavlo V Mykytenko, Bohdan M Melnyk, Galina V Khrapiichuk, Viktoriia M Rudnieva","doi":"10.36740/Merkur202603113","DOIUrl":"10.36740/Merkur202603113","url":null,"abstract":"<p><strong>Objective: </strong>Aim: Theoretical substantiation, development, and validation of a system of criteria and descriptors for monitoring the formation of professional practical skills of future gnathologists.</p><p><strong>Patients and methods: </strong>Materials and Methods: Theoretical and empirical methods were applied: a comprehensive analysis of scientific literature; comparative and generalisation methods for theoretical substantiation of systematic quality monitoring approaches; interviews with academic staff for criteria and descriptor elicitation; and a survey of gnathology specialists for problem identification and expert validation of the proposed system. We assessed the relative importance of each criterion on a 5-point scale using the following indicators: the expert competence coefficient, the generalised opinion score, the degree of consensus of opinions, and the statistical significance of the expert consensus coefficient.</p><p><strong>Results: </strong>Results: Four principal interdisciplinary integration domains relevant to gnathological training have been identified: anatomical-morphological, kinematicdynamic, system-functional, and clinical-diagnostic. A five-criterion monitoring system with four-level descriptors (basic, intermediate, advanced, and high) has been developed for each criterion: cognitive-analytical, diagnostic-interpretive, biomechanical-design, practical-operational, and prognostic-reflective. Expert evaluation confirmed the high validity of, and consensus on, the proposed system. Expert competence was assessed using the Kk coefficient (Kk=0.87). The degree of consensus was quantified via Kendall's concordance coefficient (W=0.8), with statistical significance verified by the Pearson chi-square test (χ2ₚ=28.97 > χ2ₜ=9.5; α=0.05).</p><p><strong>Conclusion: </strong>Conclusions: The developed system of criteria and descriptors constitutes a methodological framework for comprehensive monitoring of the formation of practical skills in future gnathologists. The high level of expert consensus confirms the validity and practical applicability of the proposed system for improving dental education curricula.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 3","pages":"326-330"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of vestibular disorders after stapedotomy depending on the method of stapes footplate fenestration.","authors":"Kateryna H Aktiinova, Oleg M Borysenko","doi":"10.36740/Merkur202603104","DOIUrl":"10.36740/Merkur202603104","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To compare the severity of early postoperative vestibular disorders after stapedotomy using two techniques of stapes footplate fenestration: the Skeeter microdrill and the manual perforator.</p><p><strong>Patients and methods: </strong>Materials and Methods: Sixty patients with otosclerosis who underwent stapedotomy in 2024-2025 were included in the study. The patients were randomly divided into two equal groups: Group A-stapedotomy performed using a Skeeter microdrill; Group B-stapedotomy performed using a manual perforator. Audiological assessment included pure-tone audiometry (air conduction, bone conduction, air-bone gap) and speech perception tests. Vestibular function was evaluated preoperatively and on postoperative day 7 using electronystagmography, as well as positional and static-coordination tests. An integrated clinicalinstrumental vestibular scale (0-3 points), combining clinical symptoms, Romberg and Fukuda tests, and objective ENG parameters, was applied.</p><p><strong>Results: </strong>Results: Spontaneous nystagmus on postoperative day 7 was detected in 26.7% of patients in Group A and in 40% of patients in Group B (p=0.59). The mean postoperative increase in the vestibular score was significantly lower in Group A (0.73 vs 1.23; p=0.02). Both groups demonstrated significant improvement in air-conduction thresholds and reduction of the air-bone gap, with no statistically significant intergroup differences in audiological outcomes.</p><p><strong>Conclusion: </strong>Conclusions: Both stapedotomy techniques effectively restore hearing in patients with otosclerosis. However, stapedotomy performed with a Skeeter microdrill is associated with less pronounced early postoperative vestibular disturbances compared with the manual perforator. The proposed integrated vestibular scale enables objective assessment of vestibular dysfunction in the early postoperative period and is suitable for routine clinical practice.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 3","pages":"265-271"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary tract infections in pregnant women from the Russian--Ukrainian military conflict regions: A multicenter study (2022-2025).","authors":"Aidyn G Salmanov, Anatolii Senchuk, Beraia Dzheneti, Lidiya V Suslikova, Serhii Е Savchenko, Victor O Rud, Vitalii S Strakhovetskyi, Svitlana M Korniyenko, Orusia A Kovalyshyn, Serhii Yu Vdovychenko, Andrey P Prishchepa, Olexandr V Talko, Oleksandr A Voloshyn, Andriy I Chubatyy, Ihor Paliga, Volodymyr V Artyomenko","doi":"10.36740/Merkur202602102","DOIUrl":"10.36740/Merkur202602102","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To estimates of the prevalence rate of urinary tract infections (UTIs) in pregnant women from the Ukrainian-Russian military conflict regions and antimicrobial resistance of causing pathogens.</p><p><strong>Patients and methods: </strong>Materials and Methods: Retrospective multicenter cohort study was conducted from April, 2022 to May, 2025.The study population consisted of 2,576 pregnant women from the Ukrainian-Russian military conflict regions. Antibiotic susceptibility was done by the disc diffusion test as recommended by EUCAST guidelines.</p><p><strong>Results: </strong>Results: Among 2,576 pregnant women, 1,002 (38.9%) UTIs were observed. The most frequently reported UTI types were cystitis (48.4%) and asymptomatic bacteriuria (39%). Of all UTI cases, 14.6% were defined as acute pyelonephritis. The most common causative agents of UTIs were Escherichia coli (27.6%), Klebsiella pneumoniae (13.9%), Proteus mirabilis (11.2%), Coagulase-negative staphylococci (8.7%), Enterococcus faecalis (8.5%), Enterobacter spp. (7.2%), and Pseudomonas aeruginosa (6.6%). Methicillin-resistance S. aureus (MRSA), vancomycin resistance enterococci (VRE), and extended spectrum beta-lactamases (ESBL) production among Enterobacteriales was found observed in 11.3%, 9.1%, and 29.4% isolates, respectively. Carbapenem resistance was identified in 13.7% of P. aeruginosa strains.</p><p><strong>Conclusion: </strong>Conclusions: This study findings demonstrate the high rate of UTIs in pregnant women from the Ukrainian-Russian military conflict regions and many cases are caused by pathogens that are resistant to antibiotics. Strategies for deterrence include optimal hygiene practices to minimize the risk of bacterial colonization and ascending infection.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 2","pages":"113-119"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In silico study of thiazole-based amino coumarin derivatives with promising carbonic anhydrase inhibitory activity.","authors":"Alaa H Fadel, Noor H Naser","doi":"10.36740/Merkur202604107","DOIUrl":"https://doi.org/10.36740/Merkur202604107","url":null,"abstract":"<p><strong>Objective: </strong>Aim: In this study, a series of novel aminocoumarin derivatives incorporating an amino-thiazole moiety were designed to evaluate their inhibitory activity against the carbonic anhydrase IX enzyme (PDB ID: 6fe0) and to explore their potential anti-neoplastic properties through molecular docking analysis.</p><p><strong>Patients and methods: </strong>Materials and Methods: Molecular docking was performed using the Molecular Operating Environment (MOE) software, version 2015.10. The Standard Score (S-score) and Root Mean Square Deviation (RMSD) parameters were used to evaluate the binding affinities of the ligands toward the target enzyme.</p><p><strong>Results: </strong>Results: The four synthesized ligands (IIIa, IIIb, IIIc, and IIId) demonstrated stronger binding affinities to carbonic anhydrase IX compared with the reference ligand, acetazolamide. Among them, compound IIId showed the most favorable binding profile, having an S-score of -10.6.</p><p><strong>Conclusion: </strong>Conclusions: These findings suggest that the produced 6-aminocoumarin derivatives, specifically compound IIId, could serve as promising, effective inhibitors of carbonic anhydrase with potential anti-cancer activity targeting the carbonic anhydrase IX enzyme.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 4","pages":"427-433"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of steroidal and nonsteroidal mineralocorticoid receptor antagonists on the incidence of new-onset cardiac arrhythmias following myocardial infarction: A retrospective cohort study.","authors":"Laith Rhabneh, Ra'ed Ababneh, Ibrahim Dib, Khalid Hazaimeh, Ibrahim Alnaser, Mohammed Aloqaily, Ibrahim Alfarrajin","doi":"10.36740/Merkur202604116","DOIUrl":"https://doi.org/10.36740/Merkur202604116","url":null,"abstract":"<p><strong>Objective: </strong>Aim: The purpose of this study was to compare the incidence of new-onset cardiac arrhythmias in post-myocardial infarction (MI) patients treated with nonsteroidal versus steroidal MRAs.</p><p><strong>Patients and methods: </strong>Materials and Methods: A retrospective cohort study was conducted using the TriNetX database, including MI patients without a prior history of cardiac arrhythmias who received either nonsteroidal or steroidal MRAs. Propensity score matching was performed across 28 baseline variables, including demographics, cardiovascular risk factors, medication use, and laboratory values. The primary outcome was the incidence of new-onset cardiac arrhythmia, while secondary outcomes included the individual components of the primary outcome (atrial and ventricular arrhythmias) as well as cardiac arrest events.</p><p><strong>Results: </strong>Results: After matching, 861 patients were included in each cohort (nonsteroidal and steroidal mineralocorticoid). New-onset cardiac arrhythmia occurred in 62 patients (9.1%) in the nonsteroidal group and 97 patients (15.6%) in the steroidal group. However, the risk of developing new-onset cardiac arrhythmia did not differ significantly between the two cohorts (HR: 0.856; 95% CI: 0.614-1.193; P=0.284). Secondary outcomes also showed no significant differences: atrial arrhythmia (HR: 0.752; 95% CI: 0.520-1.089; P=0.125), ventricular arrhythmia (HR: 1.016; 95% CI: 0.558-1.850; P=0.647), and cardiac arrest (HR: 0.851; 95% CI: 0.465-1.558; P=0.081).</p><p><strong>Conclusion: </strong>Conclusions: Our findings showed no difference in the incidence of new-onset cardiac arrhythmias or in secondary outcomes between patients treated with nonsteroidal versus steroidal MRAs. Prospective, standardized studies are needed to validate these results.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 4","pages":"488-499"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"War, crisis and adaptation: Resilience self-assessment in Ukrainian medical and psychological education.","authors":"Lesya V Lymar, Olha A Oseredchuk","doi":"10.36740/Merkur202604105","DOIUrl":"https://doi.org/10.36740/Merkur202604105","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To assess self-reported resilience among Ukrainian medical students, physicians, teachers, and psychologists under conditions of full-scale war and to identify the main factors and strategies supporting adaptation.</p><p><strong>Patients and methods: </strong>Materials and Methods: An original cross-sectional mixed-methods study was conducted in 2026. The questionnaire was developed following a targeted review of publications on resilience, education, and healthcare in wartime Ukraine. The anonymous Google Forms survey was distributed through communication channels to approximately 2500 potential respondents, of whom 295 responses were received (response rate: 11.8%). Quantitative data were analysed using descriptive statistics. Open-ended responses were analysed thematically.</p><p><strong>Results: </strong>Results: The sample was predominantly female (216; 73.2%) and consisted mainly of students or PhD students (214; 72.5%). Most respondents assessed their resilience as moderate or high: 101 (34.2%) reported 51-75%, and 99 (33.6%) reported >75%. The most frequent resilience resources included family relationships, social support, responsibility for others, future goals, professional activity, civic engagement, faith, routine, and self-care. The main coping strategies were cognitive reframing, acceptance, short-term planning, maintaining daily structure, social connectedness, restorative activities, and reflective practices. A smaller group reported exhaustion, lack of support, avoidance behaviours, alcohol or sedative use, and depressive symptoms.</p><p><strong>Conclusion: </strong>Conclusions: Resilience among teachers, medical students, physicians, and psychologists is an important area of study. Self-reported data indicated relatively high levels of resilience in the fifth year of full-scale war. However, the study revealed a concerning trend of depressive symptoms and emotional burnout. Strengthening resilience requires institutional support, psychoeducational interventions, and professional development activities.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 4","pages":"416-420"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health service accessibility and psychological distress among displaced populations during the armed conflict: A cross-sectional survey.","authors":"Ivan I Chervynskyy, Natalia Yu Kondratiuk","doi":"10.36740/Merkur202601104","DOIUrl":"https://doi.org/10.36740/Merkur202601104","url":null,"abstract":"<p><strong>Objective: </strong>Aim: To quantify barriers to access to essential health services and describe patterns of psychological distress and help-seeking among displaced populations during the armed conflict in Ukraine.</p><p><strong>Patients and methods: </strong>Materials and Methods: A cross-sectional questionnaire captured displacement status, linkage to primary care (declaration), perceived accessibility, barriers in the previous 6 months, awareness of reimbursement medicines, unmet service needs, and psychological symptoms within the last 2 weeks. The dataset (n=450) comprises anonymized real-world responses collected in this study.</p><p><strong>Results: </strong>Results: The 48,4% of respondents were classified as currently displaced, and 75,8% reported a primary care declaration. Primary care was rated fully accessible by 20,9%, whereas 42,7% reported difficult/very difficult access. Appointment unavailability (61,6%), lack of medicines (49,8%), and high service costs (40,0%) were common barriers. Sleep disturbance (37,6%) and anxiety/panic (36,2%) were frequent; 18,7% reported seeking any support for mental health needs.</p><p><strong>Conclusion: </strong>Conclusions: In this cross-sectional survey, access constraints clustered around appointment availability, medicine supply, and affordability, while psychological symptoms were frequent and support-seeking remained limited. Interventions should combine primary care navigation and capacity measures with integrated, stigma-sensitive mental health pathways.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 1","pages":"24-29"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"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.","authors":"Yevhen V Shaprynskyi, Vasyl M Lypkan, Yaroslav V Karyi, Oleksandr L Makhovskyi, Anatolii V Tomashevskyi","doi":"10.36740/Merkur202601101","DOIUrl":"https://doi.org/10.36740/Merkur202601101","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":39518,"journal":{"name":"Polski Merkuriusz Lekarski","volume":"54 1","pages":"5-10"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}