HIGH-ENERGY WAR WOUNDS - FLAP RECONSTRUCTION

In this article, we emphasize that knowledge of terminal ballistics is essential for understanding the pathophysiology of war wounds. We pre sent our own experiences in treatment of high-energy war wounds in 75 patients treated in the Institute of Plastic and Reconstructive Surger y, Department of Surgery, Clinical Hospital Center in Zagreb. Patients were divided into three groups with regard to the time of definite re construction, using local or free microvascular flaps. About 12% of pa tients underwent flap reconstruction in the acute phase, associated wi th low complication rate and the shortest hospital stay. Group II was comprised by 18% of the patients and, considering the number of compli cations, presented the most unfavorable time for reconstruction. Flap reconstruction in the chronic phase resulted in a substantial prolonga tion of the hospital stay in 82% of patients. Therefore, we advocate p roper primary treatment of wounds aimed at early flap closure. This ty pe of management results in a significantly shorter hospitalization an d leads to more effective rehabilitation and recovery of patients.