{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T07:11:51Z","timestamp":1789197111125,"version":"build-2803163510"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pain Res."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Given that many armed conflicts are currently ongoing worldwide, a thorough study of issues related to providing medical care for the wounded is essential.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We included 45 participants aged 20\u201360 years with limb injuries in our study. The participants were surveyed using a visual analog pain scale, the PHQ-9, and the PTSD-5. We formed three groups: the first group included patients with limb amputations, the second group consisted of patients with limb trauma, and the third group involved patients with limb burns.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that the average pain level in Group 1 was higher, though statistical significance was not achieved (<jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090,05). According to the PHQ-9, all participants exhibited depressive symptoms of varying severity. In the trauma group, patients reported fewer PTSD symptoms. Among the amputees, a significant predominance of Gram-negative microorganisms was noted. The correlation between the slightly higher pain levels and the significant predominance of Gram-negative flora in amputee patients was negative (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the amputee group, there was a trend toward higher mean pain scores compared to the other groups (<jats:italic>p<\/jats:italic>\u2009&amp;gt;\u20090,05). The same presence and distribution of depressive and PTSD symptoms were observed across all groups. Correlation analysis between pain intensity and contamination with Gram-negative bacteria did not reveal a relationship between these two variables. The study requires a larger patient sample. Gram-negative pathogens such as Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella oxytoca, and Proteus mirabilis were found more frequently among all patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpain.2025.1564994","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T05:24:55Z","timestamp":1745904295000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Early post-trauma wound microbiota and its association with pain outcomes and mental health in combat-related extremity injuries: a prospective 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