Surgical site infection in patients with combat-related injuries and wounds

Infectious complications of surgical treatment of patients suffering from combat injuries and wounds reduce the effectiveness of treatment and increase the duration of hospitalization and the cost of treatment. The aim is to analyze the results of surgical treatment of patients suffering from combat-related injuries and wounds and to determine the frequency of various types of surgical site infections (SSIs). The research methods. We conducted a retrospective cohort study of the results of surgical treatment of 2,662 patients with combat-related injured and gunshot wounds, who were in 2022–2024 in 7 civilian hospitals in 4 regions of Ukraine. Results. A total of 2662 patients with combat-related injured and gunshot wounds undergoing 3786 surgeries were included, of whom in the postoperative period 36.7% had an SSI, representing an incidence rate of 58.1% for superficial SSI, 29.3% for deep SSI, and 12.6% organ or space respectively. The highest incidence of SSIs was observed in patients with abdominal injuries — 60.7%, limbs and pelvis — 36.8%, head and neck — 30.2% and chest — 27.7%, the lowest in the vertebral area — 6.8%. It was established that the frequency of SSIs development depends on the nature of combat injuries. SSIs was most often observed in areas of mine-explosive trauma — 25.1% and gunshot wound — 10.7%, the lowest after operations in areas of combined wound — 0.9%. Conclusion. Our work shows a correlation between the presence of shrapnel, bone lesions, skin loss, and infections caused by weapons of war. This study found a high incidence of SSIs in patients with combat-related injured and gunshot wounds. The high rates of postoperative infections indicate gaps in infection control compliance in the studied hospitals. Although the military conflict in Ukraine continues, the analysis of infection-related data remains critical for optimizing current clinical practice guidelines with the overall goal of improving outcomes for combat-wounded military personnel and civilians.

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