MODERN TECHNOLOGIES FOR DIAGNOSTIC AND REMOVAL OF FOREIGN BODIES OF SOFT TISSUE OF FIRE-ORIGINAL ORIGIN
Authors: Zamyatin P. N. , Negoduyko V. V. , Mikhaylusov R. N. , Beresnyev S. A. , Provar L. V. 
Published: October 2020

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.