[Surgical management of war injuries involving soft tissue defects]. / Kirurski postupak kod ratne rane s manjkom mekog tkiva.

In this article, the authors emphasize that the knowledge of terminal ballistics is important for understanding of the pathophysiology of war wounds. They present their own experiences in the treatment of war wounds in 126 casualties, treated in the Institute of Plastic and Reconstructive Surgery, Department of Surgery, Clinical Hospital Center, Zagreb. About 96% of the wounded sustained extremity injuries, while head, neck and thoracoabdominal injuries appeared in a significantly smaller number of cases. War wound were divided into four main categories with regard to type of injury and extension of soft-tissue defect, thus showing the differences in primary excision and in reconstruction of the wounds; 78.6% of head and neck injuries were treated by primary or early primary reconstruction (within three to five days after the injuries have been sustained), while 45.4% of thoracoabdominal injuries were treated by a secondary closure. The greatest number of sophisticated reconstructions were used in extremity injuries (15 wound were reconstructed by local flaps, while free flaps were used in 8 cases). The authors emphasize the importance of proper primary treatment which enables an early reconstruction. This results in significantly shorter hospitalization, so that 87.5% of patients were treated within 20 days and then transferred to early rehabilitation.

[Transplantation of the peripheral nerves]. / Transplantacija perifernih zivaca.

The development of microsurgery made possible neurorrhapy of even very tiny peripheral nerves. In case of a transsection of a nerve without a defect or with a minor one up to 15 mm, approximation of stumps can be done directly. Larger defects are bridged with autogenous nerve grafts. In order to avoid this, novel technics like cadaveric allogenous grafts or using veins and small tubes of absorbable materials as a guiding rail have been introduced. For purpose of this degenerated muscle grafts are being also applied.