The patient A.H., 1982y/b, in the midsummer of 2015, while serving in the Army at the border of RA, has sniper gunshot wound. The patient was transferred to the hospital of Sisian, after which – to the Central Military Hospital.
The patient has bone and soft tissue defect on the middle 1/3 of the left shin. After the injury the foot was hanging on the skin and muscle flaps. The 2 of 3 main arteries of the shin were damaged. In the Central Military Hospital was used an Ilizarov apparatus for the shin bones fixation, and also for the further replacement of the tibia defect by Ilizarov method of distraction, but the existing defect of shin soft tissues is the main defect for the bone plastics. By prior arrangement for this defect correction the patient was transferred to MC Erebouni.
In 10.09.15 after the examination and preliminary preparation, under the general anesthesia by the Head of Plastic Surgery and Microsurgery Department Dr A.R. Hovhannisyan, MD, with the assistance of two teams of plastic and abdominal surgeons, was carried out the surgery; vascularized fragment of the greater omentum was isolated from the abdomen, and after preliminary preparation of the recipient vessels of the popliteal area, the graft has been moved to the wound with the replacement of the volumetric defect of soft tissues. Over the wound was placed a blair brown skin graft.
P/o period was uneventful, flaps was adopted, the patient is preparing for transfer to the Military Hospital for further treatment on replacement of the bone defect.
Preservation and restoration of the limbs at the vast complex defects requires adequate and effective replacement of anatomical structures by vascularised tissues. Due to microsurgical technologies and coordinated professional team work of the doctors today has become possible the recovery of severe injured limbs.
