Peculiarities of Pain in Patients With Mine-explosive Wounds Depending on the Localization of the Wound at the Stages of Treatment

Over the last ten years, the amount of pathology caused by mine-explosive devices has increased significantly. Mine-explosive wounds in the general structure of combat sanitary losses reach 25%. They often have a combined character. Such an injury must be considered as a multifactorial injury resulting from the combined impact on a person of a shock wave, gas jets, flames, toxic products, fragments of the hull, secondary projectiles, which cause severe injuries in the area of direct damage and the body as a whole. Mine-explosive injuries are characterized by multiple, combined or combined injuries with a high degree of severity - 8-10%. Also, even in peacetime, terrorists often use powerful explosive devices. Here, the mortality rate is 10-20% of the total number of injured, and 80-90% suffer from the consequences - mine-explosive injuries. Compared to the wars of the past, the number of seriously wounded with combined injuries has increased to 25-30%. This is primarily due to the use of high-precision ammunition and mine-explosive ammunition. In general, multiple and combined damage in local conflicts today is 25-62%. Lethality in case of mine-explosive injury reaches 37-41.4%. The mortality rate among the wounded with mine-explosive injuries who were admitted to the stage of qualified medical care was 17.4%, more than half of the wounded died as a result of blood loss. In 63.7%, death occurs in the first 24 hours after injury.The direct and most frequent causes are shock and blood loss (49.1%), destruction of vital organs (28.4%). About 90% of all combat deaths occur before the wounded reaches the first stage of treatment.

The peculiarities of pain in patients with mine-explosive wounds depending on the localization of the wound at the stages of treatment need to be studied, because the subjective feelings and emotional experiences experienced by patients during the wounding in combat conditions through the prism of psychological disorders have their own characteristics. Since in 87.2% of cases it is not possible to achieve a positive result of treatment, the data of our study will play an important role in their treatment.

• visual analog scale (Other), also known as neuropathic pain Didier Bouhassiraa (DN4)., Chaban Quality of Life Scale, The Hospital Anxiety and Depression Scale (HADS), Mississippi PTSD scale (military version): Data collection was carried out at all stages of treatment: medical and nursing brigade, military mobile hospital, military medical clinical center, during rehabilitation, within 12 months of the injury.

Primary outcomes

• visual analog scale [12 months]: from 0 to 10 points
• Didier Bouhassiraa DN4 [12 months]: 4 or more points (a neuropathic pain component is present)
• The Hospital Anxiety and Depression Scale [12 months]: 0-7 is the norm 8-13 - mild depressive disorders 14-18 - depressive disorders of medium severity 19-22 - severe depressive disorders 23 and more - depressive disorders of a very severe degree of severity
• Chaban Quality of Life Scale [12 months]: up to 56 inclusive - a very low level 57-66 - low 67-75 - average 76-82 - tall 83-100 is very high
• Mississippi PTSD scale (military version) [12 months]: the mean values of the total score are 76±18 for well-adjusted servicemen, 86±26 for servicemen with mental disorders, and 130±18 for those with PTSD

Sex: Male

Inclusion Criteria:

* the presence of gunshot wounds

Exclusion Criteria:

* no gunshot wounds