MODERN TECHNOLOGIES FOR DIAGNOSTIC AND REMOVAL OF FOREIGN BODIES OF SOFT TISSUE OF FIRE-ORIGINAL ORIGIN

  • P. N. Zamyatin
  • V. V. Negoduyko
  • R. N. Mikhaylusov
  • S. A. Beresnyev
  • L. V. Provar
Keywords: soft tissue, gunshot wounds, removal of foreign bodies.

Abstract

Summary. The work studied the epidemiological and clinical aspects of foreign bodies of soft tissues (FBST) of a firearm origin, taking into account mechanical and traumatogenesis.

Introduction. Diagnosis of FBST is usually based on complaints, history and examination data, radiographic and ultrasound examinations, and wound revisions. Some authors consider the diagnosis and removal of FBST not difficult, we consider it erroneous, since not all methods allow visualizing FBST and controlling their removal.

Objective: to improve the results of surgical treatment of injured with FBST by developing new methods for the diagnosis and removal of FBST using modern technologies.

Materials and methods. The basis of the clinical study was the experience of diagnosis and surgical treatment of 1046 wounded with the presence of gunshot FBST in accordance with the agreement between the Military Medical Clinical Center of the Northern Region (VMKC SR) and the State Institution “General and Emergency Surgery named after V.T. Zaitsev NAMS Ukraine. ”Depending on the methods used to diagnose and remove FBST, the wounded were divided into two groups: the main — 528 (50.5 ± 1.5) % (from November 2015 to May 2017) and the comparative — 518 (49.5 ± 1.5) % (from May 2014 to November 2015). Each of of the selected groups was divided into 3 subgroups depending on the completeness of the removed FBST: subgroup A — the wounded who removed the FBST in full; subgroup B — the wounded who did not remove the FBST in full (partially); B — the wounded who did not remove the FBST .

Statistical processing was carried out using the standard office suite “Microsoft Office 2013” with the application of the package “Microsoft Excel” and statistical programs for biomedical research “Biostatistics”, “Statistica 10.0”.

Results. Based on a comparison of clinical, clinical, instrumental and morphological data, the most informative functional signs of FBST were established: structure, size, shape, structure, capsule presence and indications and contraindications for FBST removal depending on localization, location depth and size were established, which made it possible to standardize data about FBST, determine the surgical tactics, the tools that are used, and improve treatment outcomes. New methods and devices have been developed and tested for determining and monitoring the completeness of FBST removal.

Conclusions. It was concluded that as a result of using the proposed modern diagnostic technologies for FBST removal, the completeness of FBST removal significantly increased from (6.2 ± 0.1) to (1.4 ± 0.1) (p <0.0000), and the duration of FBST removal decreased from (30.4 ± 1.8) to (11.2 ± 1.3) minutes (p <0.0000), the number of surgical interventions decreased from (2.8 ± 0.2) to (1.7 ± 0.1) (p <0.0000), decreased the severity of pain from (7.3 ± 0.2) to (5.2 ± 0.4) points (p <0.0000), the inpatient treatment period decreased from (18.6 ± 1.1) to (16.5 ± 1.3) days.

References

1. Zubov AD, Senchenko OV, Chernyaeva YuV. Ultrazvukovaya vizualizatsiya inorodnyih tel myagkih tkaney. Meditsinskaya vizualizatsiya. 2016;6:125-32. [In Ukrainian].
2. Mayorov EE, Prokopenko VT, Udahina SV, Tsyigankova GA, Chernyak TA. Optiko-elektronnaya kompyuternaya sistema dlya obnaruzheniya vneshnih agentov v podpoverhnostnyih sloyah kozhnogo pokrova. Meditsinskaya tehnika, 2016;2:7-10. [In Ukrainian].
3. Homenko IP, Verba AV, Horoshun EM. Harakteristika boyovoYi hIrurgIchnoYi travmi, nedolIki ta dosyagnennya v lIkuvannI poranenih I travmovanih v umovah antiteroristichnoYi operatsIYi. MIzhvIdomchiy medichniy zhurnal. Nauka I praktika. 2016;1-2 (7-8):27-31. [In Ukrainian].
4. Bell KR, Brockway JA, Fann JR, Cole WR, De Lore JS, Bush N, et al. Concussion treatment after combat trauma: Development of a telephone based, problem solving intervention for service members. Contemporary Clinical Trials, 2015;40:54-62.
5. Getman VG, Safonov VE, Kravchenko KV, ta In. StoronnI tIla grudnoYi klItki pIslya boyovoYi travmi. Zb. nauk. prats UVMA. Problemi vIyskovoYi ohoroni zdorov`ya». K: UVMA, 2017(48):78-81. [In Ukrainian].
6. Trutyak I, Gayda I, Bogdan I, Prohorenko G, Medzin V. OsoblivostI suchasnoYi boyovoYi hIrurgIchnoYi travmi. PratsI NTSh. Med. nauki, 2015(XLI):109-16. [In Ukrainian].
7. Sheyko VD. Hirurgiya povrezhdeniy pri politravme mirnogo i voennogo vremeni. Poltava: OOO «ASMI», 2015. 557 s. [In Ukrainian].
8. Zarutskiy YaL, Zaporozhan VM, BIliy VYa, Denisenko VM, ta In. VoEnno-polova hIrurgIya. Odessa: ONMedU; 2016,. 416 s. [In Ukrainian].
9. Boyko VV, ZamyatIn PM, SkIbo YuM, VasIl`Ev DO. HIrurgIya mInno-vibuhovih I vognepalnih ushkodzhen sertsya I perIkarda. MaterIali naukovo-praktichnoYi konf. Vprovadzhennya nvukovih rozrobok NAMN UkraYini ta osoblivostI nadannya medichnoYi dopomogi uchasnbkam ATO ta postrazhdalomu naselennyu» — K.: NAMNU, 2015, s. 46-7. [In Ukrainian].
10. Boyko VV, Ivanova YuV. Kompleksnoe lechenie gnoyno-vospalitelnyih zabolevaniy myagkih tkaney. HarkIvska hIrurgIchna shkola. 2017;1:11-14. [In Ukrainian].
11. Zarutskyi YaL, Shudrak AA, editor. VkazIvki z voEnno-polovoYi hIrurgIYi. KiYiv.: SPD Chalchinska NV, 2014. – 396 s. [In Ukrainian].
12. Belenkiy VA, Mihaylusov RN, Negoduyko VV. Novyiy podhod k revizii ognestrelnyih ran. Problemi vIyskovoYi ohoroni zdorov’ya. 2016;45(1): 290-95. [In Ukrainian].
13. Gerasimenko EP, Glebskiy YuV, Polyakov OI, Voytov VV, Shestopalyuk AA, Kurachenko IP, Kobza TI. Primenenie magnita dlya izvlecheniya oskolkov pri minno-vzryivnoy travme. Shpitalna hIrurgIya. 2014;4:101-3. [In Ukrainian].
14. NevIdkladna vIyskova hIrurgIya. Institut Bordena, UpravlInnya nachalnika vIyskovo-medichnoYi sluzhbi armIYi SShA. K.:UkraYinske vidannya, 2015, s. 221-33. [In Ukrainian].
15. Boyko VV, Zamyatin PN, redaktoryi. Politravma. H.: Faktor, 2011.- 640 s. [In Ukrainian].
16. Shekera O G, Votcher YuL, Kirzhner GD. VoEnno-medichna doktrina UkraYini. Novini meditsini ta farmatsIYi. 2015;1(525):16. [In Ukrainian].
17. Boyko VV, i dr. Analiz klinicheskih dannyih v meditsinskih issledovaniyah na osnove metodov vyichislitelnogo intellekta. H.:TO Eksklyuziv;2008.121s. [In Ukrainian].
18. Boyko V, Zamyatin P, Dubrovina N, Zamyatin D. Primenenie statisticheskih modeley pri prognozirovanii ishoda u postradavshih pri tyazheloy travme. KlInIchna hIrurgIya. 2014;2:39-44. [In Ukrainian].
19. 19. Lurin IA, Negoduyko VV, Mihaylusov RN. Inorodnyie tela myagkih tkaney ognestrelnogo proishozhdeniya. Klinicheskaya hirurgiya. 2018;6(2):154-5. [In Ukrainian].
20. 20. Mihaylusov RN, Negoduyko VV. Perspektivyi lazernoy vizualizatsii ognestrelnyih ran myagkih tkaney. HIrurgIchna perspektiva. 2016;1-2:19. [In Ukrainian].
21. 21. Negoduyko VV, Mihaylusov RM, BIlenkiy VA, ZamyatIn PN, RomaEv SM. SposIb dIagnostiki nayavnostI ta utochnennya lokalIzatsIYi storonnIh tIl u m’yakih tkaninah vognepalnogo pohodzhennya. Patent UkraYini #104193. 2016 sIch.12. [In Ukrainian].
22. 22. Negoduyko VV, Mihaylusov RM, BIlenkiy VA, ZamyatIn PM, RomaEv SM. SposIb provedennya obstezhennya poranenih z vognepalnimi poranennyami m`yakih tkanin. Patent UkraYini #107053. 2016 trav. 25. [In Ukrainian].
23. 23. Kashtalyan MA, Gerasimenko OS, Tertyishnyiy SV, Enin RV. Novyie napravleniya v lechenii ognestrelnyih ran. Harkovskaya hirurgicheskaya shkola. 2017;1:112-15. [In Ukrainian].
Published
2020-03-12
How to Cite
Zamyatin, P. N., Negoduyko, V. V., Mikhaylusov, R. N., Beresnyev, S. A., & Provar, L. V. (2020). MODERN TECHNOLOGIES FOR DIAGNOSTIC AND REMOVAL OF FOREIGN BODIES OF SOFT TISSUE OF FIRE-ORIGINAL ORIGIN. Kharkiv Surgical School, (3), 81-86. https://doi.org/10.37699/2308-7005.3.2020.16
Section
QUESTIONS OF SURGICAL TREATMENT OF GUNSHOT WOUNDS

Most read articles by the same author(s)

1 2 > >>