THE CONCEPT OF MONITORING THE MIGRATION OF FOREIGN BODIES OF IGNITION ORIGIN
Authors: Khoroshun E. M. , Makarov V. V. , Negoduyko V. V. , Zamіatin P. M. , Tertyshny S. V. , Veryovkin I. V. 
Published: June 2024

Resume. The goal is to determine the main directions of the components of the concept of monitoring the migration of foreign objects of firearm origin.
Materials and methods. We have analyzed 82 case histories of the wounded with cases of blind gunshot fragment wounds with migration of a foreign body by different routes and localization for a certain period. It should be noted that all the injured were male, the average age of which was 43.2±4.1 years. The wounded were examined with the help of X-ray, and according to the indications, video endoscopic methods. In comparison, mini-invasive surgical interventions using magnetic technologies prevailed, the smaller part consisted of conservative tactics of monitoring the migration of foreign bodies along the course of the organs of the gastrointestinal tract.
The results. Conceptually, the entire migration process of a foreign body of firearm origin has three stages: the place of the entrance hole, the place of the beginning of migration, the place of fixation (detection); two elements: wound channel and migration path; the direction of migration, which can change.
We have determined the main directions of the components of the concept of monitoring the migration of foreign bodies of firearm origin in the form of classification signs: the place of the entrance hole and the beginning of migration, the direction of migration, the number of foreign bodies, the structure of foreign bodies, the distance of migration, as well as the process, time, cause, frequency, fixation and volume of operative treatment referral.
Operative treatment was directed to the surgical treatment of the entrance hole of the gunshot wound (wound), the wound channel, the place of the beginning of migration, the place of fixation (location of the foreign body), and the removal of the foreign body. The direction of the migration path was taken into account to predict further migration and to prevent re-migration.
Both open approaches and mini-invasive technologies using a surgical magnetic tool were used in operative treatment.
Primary surgical treatment according to indications was performed in 57 (69.5%) cases, in 25 (30.5%) patients it was not performed. At the same time, open access was used in 23 (28%), miniinvasive - in 49 (59.8%) cases. Operative treatment directed at the place of the beginning of migration, the place of fixation (location), removal of a foreign body was not used - in 10 (12.2%) cases. Foreign bodies (metal fragments) came out naturally in 16 (19.5%) cases, in 1 (1.2%) case foreign bodies were not removed (localization in the liver) and in 65 (79.3%) cases foreign bodies were removed by using a modern magnetic surgical instrument.
Conclusions. Migration of foreign bodies of gunshot origin is a separate type of course of a gunshot wound; іsolation of two elements (wound channel and migration path) and three stages (place of entrance hole, place of origin, direction and destination of migration, place of fixation (detection)) of foreign body migration of firearm origin form a complete concept; the concept of monitoring the migration of foreign bodies of firearm origin is based on a system analysis.