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War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod

Marija Šimunović
Krešimir Tomka

Puni tekst: engleski, pdf (2 MB) str. 89-92 preuzimanja: 32* citiraj
APA 6th Edition
Šimunović, M. i Tomka, K. (1992). War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod. Medicinski vjesnik, 24 ((1-2)), 89-92. Preuzeto s https://hrcak.srce.hr/195235
MLA 8th Edition
Šimunović, Marija i Krešimir Tomka. "War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod." Medicinski vjesnik, vol. 24, br. (1-2), 1992, str. 89-92. https://hrcak.srce.hr/195235. Citirano 13.06.2021.
Chicago 17th Edition
Šimunović, Marija i Krešimir Tomka. "War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod." Medicinski vjesnik 24, br. (1-2) (1992): 89-92. https://hrcak.srce.hr/195235
Harvard
Šimunović, M., i Tomka, K. (1992). 'War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod', Medicinski vjesnik, 24((1-2)), str. 89-92. Preuzeto s: https://hrcak.srce.hr/195235 (Datum pristupa: 13.06.2021.)
Vancouver
Šimunović M, Tomka K. War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod. Medicinski vjesnik [Internet]. 1992 [pristupljeno 13.06.2021.];24((1-2)):89-92. Dostupno na: https://hrcak.srce.hr/195235
IEEE
M. Šimunović i K. Tomka, "War eye injuries cured at the eye diseases service of the Medical centre in Slavonski Brod", Medicinski vjesnik, vol.24, br. (1-2), str. 89-92, 1992. [Online]. Dostupno na: https://hrcak.srce.hr/195235. [Citirano: 13.06.2021.]
Puni tekst: hrvatski, pdf (2 MB) str. 89-92 preuzimanja: 84* citiraj
APA 6th Edition
Šimunović, M. i Tomka, K. (1992). Ratne ozljede oka liječene u Službi za očne bolesti Medicinskog centra Slavonski Brod. Medicinski vjesnik, 24 ((1-2)), 89-92. Preuzeto s https://hrcak.srce.hr/195235
MLA 8th Edition
Šimunović, Marija i Krešimir Tomka. "Ratne ozljede oka liječene u Službi za očne bolesti Medicinskog centra Slavonski Brod." Medicinski vjesnik, vol. 24, br. (1-2), 1992, str. 89-92. https://hrcak.srce.hr/195235. Citirano 13.06.2021.
Chicago 17th Edition
Šimunović, Marija i Krešimir Tomka. "Ratne ozljede oka liječene u Službi za očne bolesti Medicinskog centra Slavonski Brod." Medicinski vjesnik 24, br. (1-2) (1992): 89-92. https://hrcak.srce.hr/195235
Harvard
Šimunović, M., i Tomka, K. (1992). 'Ratne ozljede oka liječene u Službi za očne bolesti Medicinskog centra Slavonski Brod', Medicinski vjesnik, 24((1-2)), str. 89-92. Preuzeto s: https://hrcak.srce.hr/195235 (Datum pristupa: 13.06.2021.)
Vancouver
Šimunović M, Tomka K. Ratne ozljede oka liječene u Službi za očne bolesti Medicinskog centra Slavonski Brod. Medicinski vjesnik [Internet]. 1992 [pristupljeno 13.06.2021.];24((1-2)):89-92. Dostupno na: https://hrcak.srce.hr/195235
IEEE
M. Šimunović i K. Tomka, "Ratne ozljede oka liječene u Službi za očne bolesti Medicinskog centra Slavonski Brod", Medicinski vjesnik, vol.24, br. (1-2), str. 89-92, 1992. [Online]. Dostupno na: https://hrcak.srce.hr/195235. [Citirano: 13.06.2021.]

Sažetak
The service for ocular diseases was founded in 1963. In peacetime we had 24 beds, but after displacing to a more secure place the capacity was reduced to 12 beds. In the service there are five ophthalmologists, two higher grade nurses, sixteen nurses and two administrators. There were no personnel changes in comparison to prewar period. Besides treating the wounded, the service have been doing regular ophthalmic examinations of the inhabitants as well as systematic examinations of the members of Croatian Army. War eye injuries take high degree of frequency of war injuries and they are serious wounds with high degree of disablement. Although eyes take only 1% of the total body surface nd about 0,27% of the body contour (in upright position) it is well known that they appear to be 10% of all wounds. The experiences of this war show all the bigger frequency of the combined craniocerebral and mascilofacial wounds with wounded eyes and orbits. An early identifying of the eye sore, an urgent and propriate transport, a careful and correct ophthalmologic surgery and in cases of combined wounds a good cooperation of the medical team prevents serious complications and invalidity. In the history of wars as more modern and more fatal weapons were used the number of eye wounds were increased. Thus, the number of eye sores in war in 1870 year is only 0,86% of the all wounds, in RussianJapanese war 1904 - 2,22%, in Corean war (1950-53) the number of eye wounds was 8% and in Israel - Arab war in 1967 it was 10%. Our Observations: In the period from September 1991 until the end of June 1992 on Ocular department of the Medical centre 126 wounded with badly injured eyes were hospitalized as well as 25 wounded accepted on other departments of Medical centre, with combined wounds and ocular surgery done because of badly wounded eyes. Only the heaviest wounded were hospitalized in cellars, while others were treated as out patients. Almost in all cases eye injuries were recognized on the place of wounding and they were given first-aid (sterile dress). In most cases the transport of the wounded was not appropriate. The wounded were the most often transported in sitting posture driven on field trails; for all that abrupt movements of the body and head happened which caused that certain parts of the wounded eye got out of the eye socket. Of the total number of the wounded two thirds were soldiers and one third civilians. With 17% of our patients both eyes were hurt. In treatment we found the following types of injuries:
1) Perforative wounds 45 wounded 36%
2) Wounds of eyelids and orbits 41 wounded 30%
3) Nonperforative wounds 27 wounded 26%
4) Eye and poly traumatic wounds 20 wounded 15%
5) Contusion wounds 9 wounded 7,6%
6) Burns 7 wounded 4,6%
7) Blast wounds 3 wounded 2,5%
The most frequent causes of wounds were:
1) Shells 54 wounded
2) Mines 26 wounded
3) Gun-bullets 19 wounded
4) Air raids 14 wounded
5) Burns 7 wounded
6) Selfwounds 6 wounded
The worst wounds of the eyes and orbits with our wounded were the result of shell blasts, mines, bombs and their parts, or if they were showered with stones, soil and other hard parts sprung from explosions. In this cases the most often came to the piercing of sharp chips intraoculary, intraorbitaly to heavy contusions and shattering of eyes and orbits to pieces and obtuses of the inside of the eye due to the air pression from the explosion. The most frequent and the heaviest are perforative wounds of the eye. Due to the wounds from chips and particles of shell and bomb blasts, 22% of our wounded were accepted with perforations of front and back eye segment and with complete prolapse of intraocular substance, with badly injured eyelids and orbits, often with extraneous chips in orbits or in nearby sinuses and with absolute lose of eye and sight. In two cases there were direct bullet shots and the consequences were total destruction of eyeballs, shoots through orbits and lethal issue. War eye injuries ask for all the more knowledge and experience because of greater deadliness of modern arms. Such are the cases of bilateral shoots through orbits we had with nine wounded. These were the cases of transversal shoot through of both orbits with heavy destructive and perforative injury of an eye, with lesion of ethmoid sinus and breaking the sight nerve of another eye and with total blindness. On the side of cut through sight nerve we would find retrobulbous intraorbital extraneous chip. Such injuries are usually presented as academic curiosities and they happen at the attempt of suicide with shooting through temporal region. At war injuries we often find intraocular and intraorbital extraneous chips. Each extraneous chip was registrated clinically, radiologically, supersonic vibrations examination made and if needed, a CT of orbits. With all extraneous chips an electromagnetic attempt was made, but no one extraneous chip was magnetic. They were mainly alloys of copper and lead. After diagnostic proceedings on all perforative injuries of eye, injuries of eyelids and orbits, an operation was performed either by classical surgery technique or by microsurgery. Primary treatment of the wound was elaborated as well as taking to a place of wounded parts to normal anatomic relations. In 30% of perforative injuries a succesful primary elaboration with full restitution of the anatomic structures of the eye was done. In 15% of the wounded a full function is achieved. Namely, in literature dealing with war injuries some authors say that an injury of 4 mm is the utmost limit which has some prospects for a full functional restitution. With our wounded the injuries were as a rule twice as big with large defects on the tissue. In two cases endophtalmitis had been noticed and evisceration was elaborated. All wounded were given antibiotics according to war scheme. Up to now, no case of sympatic ophthalmia has been noticed. Secondary surgical treatment was applied with small number of wounded (removing of the blood from the front cave, ECCE and the correction of damaged eyelids) but due to a short period of time we don’t know whether such operations were succesful. The wounded with pathology of glassy part of the eye were sent to clinical treatment.

Ključne riječi
epidemiologic service; health protection; war

Hrčak ID: 195235

URI
https://hrcak.srce.hr/195235

[hrvatski]

Posjeta: 194 *