Treatment of gunshot wounds of extremities using physical and orthobiological methods

Currently, despite the wide possibilities in the treatment of wounds, patients with gunshot wounds of the extremities present a complex surgical task. The study included 60 patients with gunshot wounds of the extremities who underwent inpatient examination and treatment at the Center of Traumatology and Orthopedics of the Main Military Clinical Hospital named after academician N.N. Burdenko of Ministry of Defence of the Russian Federation. The patients were divided into groups. In group I, physical methods of treatment were used, such as vacuum therapy (35 people), of which 19 patients underwent combined vacuum therapy with laser irradiation of the wound (group IA), 16 patients underwent vacuum therapy in combination with high-intensity pulsed optical irradiation (group IB). Group II included patients in whom orthobiological techniques were used in the complex treatment of wounds (25 patients), including platelet-enriched fibrin glue — in 13 patients (group IIA) and a composition of heterogeneous implantable gel SpheroGEL® in the LONG version (hereinafter SpheroGEL®) — in 12 patients (group IIB). Results. Comparison of the results of the treatment revealed a significant improvement in the regenerative process according to the histological method in group IA: the maturation of mature granulation tissue was observed on the 9th day after the application of local treatment methods. Positive adhesive and wound healing effects were observed in group IIA. According to the "AnalyRan" program, there was a significant reduction in the time of wound healing in all groups under study. According to the results of the study, all techniques showed positive dynamics of wound healing and reduction of the inflammatory process.