scholarly journals TYPES OF SURGERIES PERFORMED AT NECK WOUNDS IN CIVIL MEDICAL INSTITUTION IN THE CONDITIONS OF THE LOCAL MILITARY CONFLICT

2019 ◽  
Vol 6 (1) ◽  
pp. 106-111
Author(s):  
V. V. Maslyakov ◽  
V. G. Barsukov ◽  
A. V. Uskov
Keyword(s):  
Comparison Group ◽  
Gunshot Wounds ◽  
Medical Institution ◽  
City Hospital ◽  
Airway Patency ◽  
Military Conflict ◽  
Stab Wounds ◽  
Surgical Department ◽  
Operative Exploration ◽  
Made In

Objectives. To make analysis of main types of surgeries performed at various neck wounds in civil medical institution in the conditions of the local military conflict.Patients and methods. The work is based on a retrospective analysis of the treatment of 241 patients with various neck wounds who were admitted in an urgent order to the surgical department of a city hospital in Chechen Republic from 1991 to 2000. All the wounded were divided into two groups: 129 with gunshot wounds (main group) and 112 with stab wounds of the neck (comparison group). The average age was 35 ± 5 years, dominated by males — 78%.Results. It was established that in 25 (19.3%) cases the operation was started under local anesthesia, in 45% of cases anesthesia was given to continue the surgery, in 84% intubation was made, in 16% — intravenous operations. As a result of the analysis, it was revealed that for neck gunshot wounds the following operations were most often performed: a typical tracheostomy without a laryngeal and tracheal suture in 26.3% cases; atypical tracheostomy without suture of larynx and trachea — 16.2% cases; the laryngeal or tracheal suture with tracheostomy was performed in 13.1% cases, in 12.4% of cases was performed operative exploration of neck organs.In cases of concomitant chest wounds, in 10.8% of cases, in addition to operative exploration of neck organs, thoracot­omy was performed, in most cases for suturing wounds of the esophagus.Conclusion. The study confirmed that in the wounded with neck gunshot wounds, the amount of aid consisted primar­ily in restoring airway patency, stopping bleeding and anti-shock actions.

INDICATIONS AND CONTRAINDICATIONS FOR REMOVAL OF FOREIGN BODIES OF LUNGS OF FLAMMABLE ORIGIN

2021 ◽  
pp. 43-47
Author(s):  
V. Kupriyanchuk ◽  
Y. Bunin ◽  
R. Mikhailusov ◽  
V. Negoduyko ◽  
E. Khoroshun ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Foreign Bodies ◽  
Comparison Group ◽  
Gunshot Wounds ◽  
Northern Region ◽  
Main Group ◽  
Surgical Instruments ◽  
Surgical Trauma ◽  
Surgical Interventions ◽  
Surgical Department

Summary. The purpose of the study is to establish the indications and contraindications for the removal of foreign bodies of lungs of gunshot origin. Materials and methods. In the surgical department of the surgical clinic of the Military Medical Clinical Center of the Northern Region, 207 wounded who received gunshot wounds penetrating the chest were examined. The wounded were divided into 2 groups depending on the operational tactics used. The main group of 97 wounded who were treated using modern video endoscopic technology and magnetic surgical instruments. The comparison group consisted of 110 wounded who received traditional treatment. Results and their discussion. Using video endoscopic technologies and magnetic surgical instruments during surgery, 42 (54.5%) in the main group were removed, in the comparison group — 23 (27.4%) foreign bodies. The amount of surgery should not exceed the amount of damage that minimizes surgical trauma. The article presents indications and contraindications to the removal of foreign bodies of pulmonary origin. The differential approach allows to determine the surgical tactics depending on the location of the foreign body, its size and the fit of foreign bodies to the vessels, bronchi, mediastinum. Adherence to the rules of removal of foreign bodies of the lung, depending on the location of its location and size leads to a decrease in inappropriate surgical interventions and postoperative complications. Conclusions. 1. The distribution of foreign bodies by location and size allows you to clearly determine the tactics of treatment and avoid postoperative complications. 2. Surgical interventions to remove foreign bodies should be performed in the first days after stabilization of the patient’s condition using minimally invasive technologies.

Features of the development of traumatic pancreatitis with gunshot wounds to the abdomen

2021 ◽  
Vol 23 (1) ◽  
pp. 101-108
Author(s):  
Nikita I. Myasnikov ◽  
Vyacheslav V. Panov ◽  
Mariyama R. Ba ◽  
Igor Y. Kim ◽  
Kazibek B. Chakalsky ◽  
...  
Keyword(s):  
High Probability ◽  
Gunshot Wound ◽  
Gunshot Wounds ◽  
Pancreatic Injury ◽  
Lateral Impact ◽  
Timely Manner ◽  
Military Conflict ◽  
Diagnostic Potential ◽  
Traumatic Pancreatitis ◽  
Diagnostic Capabilities

The features of the development of traumatic pancreatitis in gunshot wounds of the abdomen, which present difficulties in timely diagnosis, are considered, hypotheses are formulated for studying the problem. Two clinical cases of developing traumatic pancreatitis against the background of a gunshot wound to the abdomen with indirect damage to the pancreas are presented. Without taking into account the peculiarities of the formation of the wound canal relative to the organs of the abdomen, in conditions of limited diagnostic potential, there is a high probability of late diagnosis of traumatic pancreatitis, especially in indirect damage. Injuries to the organs of the upper half of the abdomen can be risk factors for indirect damage to the pancreas due to the effect of lateral impact energy and the formation of a temporary pulsating cavity. In general, the management of such wounded in a surgical hospital with limited diagnostic capabilities or with stage treatment in a local military conflict requires the surgeon to know the peculiarities of the course of traumatic pancreatitis, which make it possible to prevent the development of complications in a timely manner. The development of traumatic pancreatitis in penetrating gunshot wounds to the abdomen is not always a consequence of direct pancreatic injury. This circumstance must always be taken into account during a diagnostic laparotomy.

Injuries to the Spleen and Diaphragm

2020 ◽  
Author(s):  
Andrea M. Long ◽  
Preston R Miller ◽  
J. Jason Hoth
Keyword(s):  
Motor Vehicle ◽  
Gunshot Wounds ◽  
Organ Injury ◽  
Trauma Patients ◽  
Left Hemithorax ◽  
Stab Wounds ◽  
Computed Tomographic ◽  
Abdominal Organs ◽  
Left Diaphragm ◽  
Liver Injuries

The spleen is one of the most commonly injured abdominal organs in blunt trauma patients. The mechanisms of injury are similar to those seen with liver injuries: motor vehicle collisions, automobile-pedestrian collisions, falls, and any type of penetrating injury. Stab wounds to the abdomen are less likely to cause spleen injury compared with liver injury due to the spleen’s protected location. Stab wounds to the spleen typically result in direct linear tears, whereas gunshot wounds result in significant cavitary injuries. This review covers injuries to the spleen and injuries to the diaphragm. Figures show findings on imaging that may be associated with failure of nonoperative management for splenic injuries, intraparenchymal splenic blush noted on an initial computed tomographic scan, the first step in mobilizing the spleen by making an incision in the peritoneum and the endoabdominal fascia, beginning at the inferior pole and continuing posteriorly and superiorly, splenorrhaphy performed using interrupted mattress sutures through pledgets along the raw edge of the spleen, left diaphragm ruptures evident with the gastric bubble located in the left hemithorax, whereas right-sided ruptures present with the appearance of an elevated hemidiaphragm, and the use of Allis clamps to approximate the diaphragmatic edges, with the defect closed with a running No. 1 polypropylene suture. The table lists American Association for the Surgery of Trauma organ injury scales for diaphragm and spleen. This review contains 6 figures, 1 table, and 55 references Keywords: spleen, injury grading, angioembolization, splenorrhaphy, splenic salvage

Stab wounds to the neck. Treatment in the city hospital. (case study)

10.12737/7383 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 0-0
Author(s):  
Науменко ◽  
E. Naumenko
Keyword(s):  
Blood Loss ◽  
Soft Tissues ◽  
Skin Incision ◽  
External Carotid ◽  
Left Shoulder ◽  
City Hospital ◽  
Jugular Veins ◽  
Stab Wounds ◽  
Packed Red Blood Cells

A clinical case study with patients with severe combined stab wounds to the neck and left shoulder. During the operation, the effective intubation wounded carried anesthetist available through a wound on the front of the neck, which communicates with the cavity ro-toglotki. Made a temporary stop bleeding by applying hemostatic zazhi-atoms. Intraoperatively administered broad-spectrum antibiotics. Introduced tetanus anatok-syn. With further audit revealed multiple injuries external jugular veins, facial veins and mandibular artery extending from the external carotid artery. Produced by ligation of these suck-ing, dressing which does not lead to a violation of cerebral circulation. Achieved sustained hemostasis. Next was performed upper tracheostomy: additional skin incision above the sternal notch. Mouth-stalled nasogastric tube, the wound washed abundantly with antiseptic solutions. Skill layering suturing mucosa of the oropharynx. Also gastrostomy was performed to unload the esophagus and postoperative enteral nutrition. At the same time packed red blood cells transfused, and fresh frozen plasma to replenish blood loss. Hyoid hemmed bottom to the soft tissues of the oral cavity, oropharynx restored. There are three silicone drainage tube into the cavity of the wound. Soft tissues are compared and sutured with interrupted sutures individual. After operation on the third day were removed from drainage surgery. On the 4th day postoperative period - the state of the injured is stable, heavy, in the mind of the patient is adequate. Recommended in such cases, pay particular attention to the ongoing external and / or roto-pharyngeal bleeding, signs of shock and acute massive blood loss. On hard or fast growing hematoma in the neck; on the dislocation, obstructive, stenotic, valves, suction asphyxia; on the growing phenomenon of respiratory failure; appearing on or exacerbated by focal neurological symptoms.

Maxillofacial Gunshot Wounds

2015 ◽  
Vol 30 (3) ◽  
pp. 316-319 ◽  
Author(s):  
Olga Maurin ◽  
Stanislas de Régloix ◽  
Stéphane Dubourdieu ◽  
Hugues Lefort ◽  
Stéphane Boizat ◽  
...  
Keyword(s):  
Suicide Attempts ◽  
Spinal Fractures ◽  
Gunshot Wounds ◽  
Mandibular Ramus ◽  
Publication Type ◽  
Hemorrhage Control ◽  
Airway Patency ◽  
Nerve Paralysis ◽  
Spinal Stabilization ◽  
The Face

AbstractThe majority of maxillofacial gunshot wounds are caused by suicide attempts. Young men are affected most often. When the lower one-third of the face is involved, airway patency (1.6% of the cases) and hemorrhage control (1.9% of the cases) are the two most urgent complications to monitor and prevent. Spinal fractures are observed with 10% of maxillary injuries and in 20% of orbital injuries. Actions to treat the facial gunshot victim need to be performed, keeping in mind spine immobilization until radiographic imaging is complete and any required spinal stabilization accomplished. Patients should be transported to a trauma center equipped to deal with maxillofacial and neurosurgery because 40% require emergency surgery. The mortality rate of maxillofacial injuries shortly after arrival at a hospital varies from 2.8% to 11.0%. Complications such as hemiparesis or cranial nerve paralysis occur in 20% of survivors. This case has been reported on a victim of four gunshot injuries. One of the gunshots was to the left mandibular ramus and became lodged in the C4 vertebral bone.MaurinO, de RégloixS, DubourdieuS, LefortH, BoizatS, HouzeB, CulomaJ, BurlatonG, TourtierJP. Maxillofacial gunshot wounds. Prehosp Disaster Med. 2015;30(3):14.

scholarly journals To the 140th anniversary of the legendary Professor of surgery V.F. Voyno-Yasenetsky (Archbishop Luka)

2018 ◽  
Vol 20 (1) ◽  
pp. 257-260
Author(s):  
T Sh Morgoshiya ◽  
V Ya Apchel
Keyword(s):  
Sciatic Nerve ◽  
Regional Anesthesia ◽  
Posterior Part ◽  
Gunshot Wounds ◽  
Fatty Tissue ◽  
Anatomical Landmarks ◽  
City Hospital ◽  
Operative Surgery ◽  
Topographical Anatomy ◽  
The University

The main milestones of life and professional path of an outstanding surgeon of the 20th century Voyno-Yasenetsky (Archbishop Luka) are considered. In 1915, Voino-Yasenetsky published a book «Regional anesthesia» in Staint Petersburg with his own illustrations, and in 1916 he defended his doctoral dissertation in Moscow University on regional anesthesia: the thesis was awarded the prize of the University of Warsaw. In 1917-1930s he worked in Tashkent - the first doctor-surgeon of the city hospital, and from March 1917 - a chief doctor. Since 1920 Voyno-Yasenetsky became a Professor of topographical anatomy and operative surgery at newly established Turkestan University. Voyno-Yasenetsky made great contributions to practical surgery. In his honor several operation were named: resection of affected by purulent process in the sacroiliac joint, the posterior part of the Ilium (pelvic resection by Voyno-Yasenetsky), operation of excision of the affected skin and fatty tissue of the axillary fossa when multiple hidradenitis (Voyno-Yasenetsky operation), incision in the popliteal fossa, supplementing arthrotomy purulent chase (cut by Voyno- Yasenetsky). Also he worked on other problems of clinical surgery. Voyno-Yasenetsky invented the original closure method of the wound located on the periphery of the diaphragm (Voyno-Yasenetsky method). He proposed a new method of spleen mobilization and ligation of blood vessels during splenectomy (Voyno-Yasenetsky method). He described important for surgeons topographic- anatomical landmarks - the projection of the sciatic nerve on the skin back of thigh (Voyno-Yasenetsky line) and the place of exit of the sciatic nerve under the gluteal folds (Voyno-Yasenetsky point). For the books «Sketches of purulent surgery» (1943) and «Late resections of infected gunshot wounds of the joints» (1944) in 1946 he was awarded the Stalin prize of the first degree. Since 1946, in connection with the illness, he departed from surgical activity and before the end of his life he lived in Simferopol (Crimea).

scholarly journals Surgical tactics for victims of gunshot wounds of the diaphragm specialized stage of medical care in conditions of a modern armed conflict

2019 ◽  
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Comparison Group ◽  
Care Delivery ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Gunshot Wounds ◽  
Main Group ◽  
Lung Capacity ◽  
Combat Injuries

Introduction. The diaphragm gunshot wounds are serious combat injuries. The main functions of the diaphragm are to change the intra-abdominal pressure and the outflow of lymph and blood from the abdominal cavity due to the constant contraction and relaxation. Therefore, when it is injured at the same time with a powerful painful impulse, cardiopulmonary disorders quickly arise. Purpose: To improve the results of surgical treatment of patients with gunshot wounds through the introduction of new video endoscopic technologies at the stage of specialized surgical care. Materials and methods. The article analyzes the features of specialized surgical care in 64 patients with gunshot wounds who were treated at the surgical clinic of the Military Medical Clinical Center of the Northern Region (III level of medical care). New minimally invasive methods are proposed to improve the outcomes of surgical treatment of victims with diaphragm gunshot wounds at level III of health care delivery. Results. Thus, the use of video thoracoscopic technique in the surgical treatment of the diaphragm wound and its suturing in the proposed method allowed to improve the results of treatment by increasing the average value of diaphragmatic excursion in deep breath in the main group to 3.73 ± 0.31 cm, whereas in the comparison group 2.21 ± 0.38 cm. The severity of the pain syndrome on the of Visual Аnalogue Scale 5 days after surgical treatment was 5.2 ± 2.3 points in the injured main group, 6.7 ± 2.1 points in the comparison group. The ratio of vital lung capacity to the required vital lung capacity in the main group was 75.3 ± 2.2%, in the comparison group 64.1 ± 1.7%. Conclusions. The use of video thoracoscopy increases the efficiency of the diagnosis of gunshot wounds of the diaphragm. The use of laser imaging and fluorescence diagnosis of diaphragm wounds ensure the adequacy of the removal of paravulary necrotic tissues. The suturing of the wounds in accordance with the anatomical and functional structure of the diaphragm with the use of plaques improves the immediate postoperative results of surgical treatment.

scholarly journals Peculiarities of sensory development in children in terms of military conflict depending on the type of feeding

2017 ◽  
Vol 8 (2) ◽  
pp. 44-49
Author(s):  
Irina B Ershova ◽  
Tatiana V Shirina ◽  
Tatiana A Goncharova
Keyword(s):  
Shock Absorber ◽  
Comparison Group ◽  
Control Group ◽  
Auditory Function ◽  
Control Groups ◽  
Military Conflict ◽  
Psychological Techniques ◽  
Sensory Development ◽  
The Military ◽  
Breast Fed

The aim of the research is to study the state of sensory functions in infants who were born and living in the Lugansk and Donetsk during the military conflict. Materials and methods. A dynamic clinical examination was made. Also it was made the assessment of the rate sensory development in 65 children in the area of military conflict. Among them 32 children were breast-fed, the main group of children (MGCh), and 33 children who were bottle-fed, formed the comparison group (CGCh). The control groups of our study consist of 73 children: 36 children (CGCh) who were breast-fed, and 37 children who were bottle-fed. There was a control group of comparison children (CGCCh) outside the zone of military conflict. The assessment of the level of sensory development of children was carried out using a standardized clinical-psychological techniques “Gnome”. Conclusions: the military conflict adversely affects the sensory development of children who were precisely in the area of conflict. The weakest spot was auditory function of children. It indicates the auditory hypersensitivity. The second place in terms of violations takes the reflex tactile sensitivity, the level of which depends on the age of the child and type of feeding. Breastfeeding is a powerful shock absorber of distressful influences of the military acts, that taking place in the environment of children. Children who have experienced the stress of war need the necessary rehabilitation measures.

scholarly journals New Approaches In The Diagnosis Of Oral Hemangiomas

2020 ◽  
Vol 2 (08) ◽  
pp. 50-57
Author(s):  
Karimov M.A. ◽  
Mamarasulova D.Z. ◽  
Sadykov R.R. ◽  
Nurmatova Kh.Kh.
Keyword(s):  
Comparison Group ◽  
Scientific Work ◽  
Infantile Hemangioma ◽  
Pyogenic Granuloma ◽  
Medical Institute ◽  
Vascular Tumors ◽  
City Hospital ◽  
Medical Academy ◽  
Congenital Hemangioma

Scientific work was carried out on the basis of the Tashkent Medical Academy, Department of Surgery (1st city hospital), and Andijan Medical Institute, Department of Oncology from 2015-2020.  Clinical material includes 175 patients.  The comparison group consisted of 100 patients who were treated in various hospitals in Tashkent and regions of Uzbekistan.  According to the classification of vascular anomalies, the majority of patients with benign vascular tumors (DBT) were diagnosed with infantile hemangioma (IG) - 82.0%, congenital hemangioma (VH) - 11.4%, pyogenic granuloma (PG) - 5.8%.  Average age of patients: children - 1.2 ± 0.4, adults - 27 ± 1.2 years.  The frequency of DSO in girls was 78%, in boys - 22%.  Localization area: lip - 57.6%, cheek 8%, tongue 26.3%.  Complications of DSO: anatomical disorders, edema, bleeding, pain, infection, respiratory disorders occurred in 83.7% of patients.

scholarly journals Resource-based approach to defining human resource policy in medical organizations

2021 ◽  
Vol 20 (3) ◽  
pp. 78-84
Author(s):  
A. F. Chernavsky ◽  
I. N. Boltasev ◽  
L. A. Garkusheva
Keyword(s):  
Personnel Management ◽  
Preventive Measures ◽  
Medical Institution ◽  
City Hospital ◽  
Organizational Changes ◽  
Medical Organization ◽  
Personnel Policy ◽  
Definition Of ◽  
Autonomous Institution

Purpose of work — analysis of modern scientific literature on the resource approach to the definition of personnel policy in medical organizations, analysis of personnel management system, personnel policy in a particular medical organization, justification of definition: "Personnel policy is personnel management, which is carried out taking into account the levels of organizational and economic, socio-psychological (huemonizing), legal, technical (5S, lean production, medical organization of a new type), training and pedagogical (mentoring) in combination and interrelation with the determining role of socioeconomic factors of the surrounding society". Materials and methods. The subject of the study — personnel policy in a medical institution on the example of the State Autonomous Institution «Serov City Hospital», using certain resources for the formation of its levels. The following methods were used in the study: analysis, classification, synthesis of scientific theoretical literature on the problem of research; analysis of documents related to the activities of a medical institution, comparison, socio-psychological testing of a number of mental and psychophysiological functions of medical workers in the professional environment. Results and discussion. The definition of "personnel policy" in a medical organization is clarified, taking into account the systematic and resource-based approach. Recommendations on the implementation of personnel policy in Serov City Hospital during the period of organizational changes and preventive measures to prevent the spread of COVID-19 were developed. Conclusion. The use of a systematic approach in the formation of personnel policy, taking into account the organizational and economic, sociopsychological, legal, technical, training and educational levels proposed by us in the aggregate and interrelation, with the determining role of socio-economic factors, allows to solve the most important issues of sustainable functioning of the medical institution in the period of organizational changes and preventive measures to prevent the spread of COVID-19.

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