COURSE OF THE IMMEDIATE POSTOPERATIVE PERIOD IN GUNSHOT WOUNDS OF ABDOMEN IN THE SECOND PERIOD OF TRAUMATIC DISEASE

Aim. To study the course of the immediate postoperative period in gunshot wounds in the second period of traumatic disease. Materials and Methods. To achieve the set aim, retrospective study of the course of the immediate postoperative period was conducted in 35 patients who were on treatment for gunshot wounds of the abdomen. All wounds were penetrating gunshot wounds. A wounded individual was delivered to a medical institution not more than in 35 minutes after injury, the average time of delivery was 27±5 min. All the wounded were men of the average age 35±6 years. Activity of endotoxicosis was investigated through determination of the level of malondialdehyde, of superoxide dismutase of erythrocytes, of urea, of creatinine, and also by the total antioxidant activity. Malondialdehyde was determined in the test with addition of thiobarbituric acid by method of I.D. Stalnaya, T.G. Garishvili (1977). Activity of superoxide dismutase of erythrocytes was determined by spectrophotometric method proposed by H.P. Misra и J. Fridovich (1972) in modification of O.G. Sarkisyan (2000). Concentration of C-reactive protein in blood serum was determined by immunoturbidimetric method. Statistical analysis procedures were carried out using IBM SPSS Statistics 24.0 program. Multiple comparisons were conducted with use of analog of dispersion analysis for non-parametric distributions – Kruskall-Wallis test. Results. In result of the conducted research it was found that the second period of traumatic disease in abdominal gunshot wounds started in 8.3±0.8 hours after the moment of injury, and completed in 47±3.4 hours after the moment of injury. This period is characterized by disintegration of metabolic processes of the organism manifested by lactate metabolic acidosis which worsens damage to cell membranes and leads to death of cell. All results in accumulation of various products with development of endotoxicosis. Alterations of parameters of peroxide oxidation of lipids in the second period of traumatic disease in gunshot wounds of the abdomen reflect severe changes and are manifested by endogenous intoxication that lead to different complications in the immediate postoperative period. Analysis of the course of the immediate postoperative period in abdominal wounds revealed deve-lopment of multiple organ failure in 51.4% of observations. From this it follows that the second period of traumatic disease in gunshot wounds of the abdomen runs a severe course with development of multiple organ failure which must be taken into account in management of such patients. Conclusions. 1) The second period of traumatic disease in gunshot wounds of the abdomen began in 8.3±0.8 hours from the moment of injury, and completed in 47±3.4 hours from the moment of injury. 2) This period was characterized by alterations of parameters of peroxide oxidation of lipids and by development of severe endogenous intoxication. 3) Development of multiple organ failure in gunshot wounds of the abdomen in this period was noted in 51.4% of wounded.