Negative pressure wound therapy in a patient with an extensive soft tissue defect of the shoulder after a mine-blast injury

Introduction. Contemporary combat trauma surgery is characterized by a high incidence of extensive soft tissue defects resulting from gunshot and blast injuries, which underscores the relevance of developing and refining surgical treatment modalities for this patient population. The absence of standardized algorithms for managing patients with extensive soft tissue defects during the stages of treatment selection and defect reconstruction creates substantial challenges in clinical practice and underscores the necessity of an individualized approach. The authors present a clinical case of successful application of negative pressure wound therapy in the comprehensive surgical management of a patient with a severe combined shrapnel injury to the upper extremity and an extensive soft tissue defect of the shoulder. Description of the clinical case. This case report describes combat trauma secondary to a severe combined shrapnel injury to the upper extremity, characterized by a comminuted gunshot fracture of the proximal humerus (type C1), axillary vein injury, and an extensive, massive soft tissue defect of the anterior shoulder, further complicated by a protracted wound healing course and the onset of traumatic illness.