Surgical aspects of dermatological military medical examination: problems and prospects

Abstract

Introduction. The current state of military medical examination of persons conscripted into the ranks of the Armed Forces of Ukraine (FSU) does not meet the requirements of wartime and is based on the order of the Ministry of Defense of Ukraine No. 402 dated 14.08.2008. Currently, this type of examination is performed by a dermatologist, without the use of current diagnostic methods, which potentially increases the risk of detecting serious skin diseases in the ranks of the Armed Forces and significantly reduces combat effectiveness and increases material costs.

The purpose of this work is to search the modern literature and compare modern recommendations with similar recommendations from developed countries, which contain simple and fairly reproducible instructions for conducting a military medical examination and have a wider admission to military service of patients with skin neoplasms.

Materials and methods. Using methods of systematic, bibliosemantic and retrospective analysis, scientific publications and guidelines were studied with the involvement of electronic databases MEDLINE/PubMed, EMBASE/Excerpta Medica, Cochrane Library, PubMed and Google Scholar. 10 publications were analyzed in depth in 15 years, which were included in our review regarding the list of diseases and conditions of the skin, methods of examination and diagnosis, regulatory documents (orders) of the medical service of the Armed Forces of Ukraine and the Armed Forces of Germany in order to determine the degree of suitability for military service, wearing military uniform clothes, shoes and special equipment.

Results. The analyzed regulatory documents do not allow effective examination of dermatological diseases, and are based on outdated data. It was found that there is no nomenclature of conditions of clinical, laboratory and morphological signs that should be taken into account by every specialist conducting a dermatological examination of a specific person. A preliminary analysis of literature data on determining the professional suitability of conscripts and servicemen of the Armed Forces with benign and malignant skin neoplasms was carried out. A set of examinations has been defined, the use of which provides a military medical examination of candidates for military service and admission to service of active military personnel.

Conclusions. It was established that the modern military medical examination of dermatological patients needs to be reformed taking into account the achievements of dermatology and trends in military medicine in developed countries. It is shown that the orders and regulatory documents valid today do not meet the modern requirements for conducting a high-quality military medical examination of patients with diseases of the skin and subcutaneous tissue. Existing regulatory documents first of all require correction, which consists in clearly defining the conditions and diseases of persons undergoing military medical examination for diseases of the skin and subcutaneous tissue, in particular oncodermatology.