The structure and experience of treating combat-related abdominal trauma in civilian casualties
- 1Zaporizhzhia State Medical and Pharmaceutical University
Abstract
Relevance. The nature of combat-related surgical injuries changes over time, driven by developments in weapons and the specific nature of combat operations. At the same time, wounds and injuries to internal organs remain among the most challenging cases for surgeons. Despite advances in modern surgery and pharmacology, the incidence of post-operative complications in combat-related abdominal trauma remains between 54 and 81 per cent, whilst the mortality rate ranges from 12 to 31 per cent.
Objective. To analyse the pattern, clinical features and treatment outcomes of combat-related abdominal trauma in civilian patients, and to identify factors associated with in-hospital mortality.
Materials and methods. A retrospective analysis was conducted of the treatment outcomes of 616 civilian patients with injuries sustained as a result of combat operations between 2022 and 2025. A separate group of 69 patients with penetrating abdominal wounds was examined. The mechanism of injury, the number of affected organs, surgical management, complications and mortality rates were analysed. The severity of the injury was determined using the Injury Severity Score (ISS). A comparative analysis was carried out between groups of patients who survived and those who died.
Results. The incidence of mine-blast injuries was 95 per cent. Abdominal organ injury was detected in 15.3 per cent of patients, with penetrating injuries accounting for 73.4 per cent of cases. The small intestine (50.8 per cent) and the large intestine (38.5 per cent) were the most commonly affected organs. In patients who died, the injury severity score (ISS) (31.9 points) was statistically significantly (p < 0.05) higher than in survivors (15.8 points). Multiple organ injuries, damage to major blood vessels, the need for damage control surgery and massive transfusion therapy were associated with increased mortality. The overall mortality rate for abdominal trauma was 24.6 per cent, with 50 per cent of patients dying within the first 24 hours. Infectious complications occurred in 25 per cent of patients, and severe post-operative complications in 15 per cent.
Conclusions. Combat-related abdominal trauma in civilian patients is characterised by a high degree of severity, frequent associated injuries and significant rates of early mortality. Key predictors of poor treatment outcomes include a high ISS score, multiple organ injuries, vascular trauma, and the need for damage control surgery and massive transfusion. The findings of this study highlight the need to standardise treatment approaches and adapt the basic principles of Enhanced Recovery After Surgery (ERAS) to the specific conditions of emergency trauma surgery in wartime.
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BibTeX
@article{gubka2026structure,
title = {{The structure and experience of treating combat-related abdominal trauma in civilian casualties}},
author = {V. O. Gubka and A. S. Protsenko},
journal = {Український журнал клінічної хірургії},
year = {2026},
month = oct,
doi = {10.26779/2786-832x.2026.5.03},
url = {https://doi.org/10.26779/2786-832x.2026.5.03},
note = {CC BY},
}
RIS
TY - JOUR
TI - The structure and experience of treating combat-related abdominal trauma in civilian casualties
AU - V. O. Gubka
AU - A. S. Protsenko
PY - 2026
DA - 2026/10/23
JO - Український журнал клінічної хірургії
DO - 10.26779/2786-832x.2026.5.03
UR - https://doi.org/10.26779/2786-832x.2026.5.03
AB - Relevance. The nature of combat-related surgical injuries changes over time, driven by developments in weapons and the specific nature of combat operations. At the same time, wounds and injuries to internal organs remain among the most challenging cases for surgeons. Despite advances in modern surgery and pharmacology, the incidence of post-operative complications in combat-related abdominal trauma remains between 54 and 81 per cent, whilst the mortality rate ranges from 12 to 31 per cent. Objective. To analyse the pattern, clinical features and treatment outcomes of combat-related abdominal trauma in civilian patients, and to identify factors associated with in-hospital mortality. Materials and methods. A retrospective analysis was conducted of the treatment outcomes of 616 civilian patients with injuries sustained as a result of combat operations between 2022 and 2025. A separate group of 69 patients with penetrating abdominal wounds was examined. The mechanism of injury, the number of affected organs, surgical management, complications and mortality rates were analysed. The severity of the injury was determined using the Injury Severity Score (ISS). A comparative analysis was carried out between groups of patients who survived and those who died. Results. The incidence of mine-blast injuries was 95 per cent. Abdominal organ injury was detected in 15.3 per cent of patients, with penetrating injuries accounting for 73.4 per cent of cases. The small intestine (50.8 per cent) and the large intestine (38.5 per cent) were the most commonly affected organs. In patients who died, the injury severity score (ISS) (31.9 points) was statistically significantly (p < 0.05) higher than in survivors (15.8 points). Multiple organ injuries, damage to major blood vessels, the need for damage control surgery and massive transfusion therapy were associated with increased mortality. The overall mortality rate for abdominal trauma was 24.6 per cent, with 50 per cent of patients dying within the first 24 hours. Infectious complications occurred in 25 per cent of patients, and severe post-operative complications in 15 per cent. Conclusions. Combat-related abdominal trauma in civilian patients is characterised by a high degree of severity, frequent associated injuries and significant rates of early mortality. Key predictors of poor treatment outcomes include a high ISS score, multiple organ injuries, vascular trauma, and the need for damage control surgery and massive transfusion. The findings of this study highlight the need to standardise treatment approaches and adapt the basic principles of Enhanced Recovery After Surgery (ERAS) to the specific conditions of emergency trauma surgery in wartime.
SN - 2786-832X
SN - 2786-8311
ER -