Application of the method of ultrasound imaging in the removal of foreign bodies in gunshot wounds.

Summary. The arms — to analyze the evolution of the development of modern surgical instruments in gunshot wounds chest. Materials and methods. 80 cases of using a modern magnetic surgical instrument for penetrating gunshot wounds of the chest were analyzed. Intraoperatively used: a magnetic multifunctional tool for the diagnosis and removal of metallic ferromagnetic foreign bodies, a flexible device for removing ferromagnetic foreign bodies, a magnetic tool for endovideoscopic diagnosis and removal of metallic ferromagnetic foreign bodies from the abdominal and pleural cavities, a magnetic nozzle for video endoscopic surgical interventions. When removing metal foreign bodies, the following methods were used: a method for preliminary determination of the material and properties of a foreign body, a method for video endoscopic laser visualization of the internal organs of the abdominal and pleural cavities. Results. Foreign bodies of the pleural cavity were diagnosed in 80 (100 %) wounded according to СT. Ferromagnetic metal foreign bodies of a gunshot origin of the pleural cavity were removed both during thoracotomy or minithoracotomy, and during thoracoscopic surgical interventions using the method of video endoscopic laser visualization of the internal organs of the abdominal and pleural cavities. The most convenient tool was the endoscopic magnetic tool for removing foreign bodies from the pleural or abdominal cavities. A magnetic nozzle for video endoscopic surgical interventions allows navigation both in the pleural cavity and along the wound channel. Conclusions. 1. The development of a surgical magnetic instrument was phased and began with the improvement of a surgical magnetic instrument to remove ferromagnetic foreign bodies of soft tissues. 2. The improvement of the tool took place as the restrictions on the use of the existing tool were established, which was a prerequisite for the development of a new tool. 3. It is advisable to create a special set of surgical magnetic instruments for video endoscopic surgery.

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Stage Reconstructive and Restorative Surgical Treatment of Gunshot Wounds of the Groin, Scrotum and Penis (Case Report)

Health of Man ◽

10.30841/2307-5090.3.2021.246214 ◽

2021 ◽

pp. 85-90

Author(s):

Serhii Golovko ◽

Oleksandr Savytskiy ◽

Oleksandr Netrebko ◽

Yevhen Bidula ◽

Volodymyr Bondarchuk

Keyword(s):

Surgical Treatment ◽

Gunshot Wound ◽

Foreign Bodies ◽

Soft Tissues ◽

Gunshot Wounds ◽

Soft Tissue Defects ◽

Initial Stage ◽

The Right ◽

Upper Third ◽

Tissue Defects

The frequency of external genital lesions in armed conflicts can reach up to 5%. The complexity of gunshot wounds is the presence of significant soft tissue defects, widespread necrosis around the wound, the possibility of progression in the hours and days after injury, the high probability of infection, and the presence of foreign bodies. The tactics of gunshot wounds are determined by the location, nature and extent of damage to soft tissues, organs, large vessels, nerves, bones and includes several stages. At the initial stage, bleeding is stopped, hematomas and foreign bodies are evacuated, non-viable tissues are removed, drainages are installed and skin defects are closed. The stage of reconstructive surgery can be started when the active wound process is over. In this report, we present a clinical case of a 22-year-old man who received a gunshot wound to the right groin, upper third of the right thigh, perineum and external genitalia in a combat zone of Operation Allied Forces, Ukraine. Bullet wound led to: damage to the skin and subcutaneous tissue in the right buttock, right groin, on the inner surface of the upper third of the thigh, penis (skin defect up to 1/3 of the circumference), scrotum, partial destruction of corpora cavernosa, m. iliopsoas and adductor muscles of the thigh, sphincter of the rectum, crushing of the right testicle. The wound was contaminated with earth and foreign bodies At the initial stage, the patient underwent: primary surgical treatment of a gunshot wound, suturing of cavernous bodies with sutures, fixation of the penis in the groin, removal of the right testicle, tamponade of the wound, sigmostomy (due to sphincter damage). Subsequently, the patient underwent regular surgical treatment of wounds, a vacuum suction system VAC was installed. After 7 months (upon completion of the healing process) suturing of the sigmostoma was performed. After 2 months, the penis and the scrotum were reconstructed. Preoperative examination (ultrasound of the penis with assessment of cavernous hemodynamics, MRI) revealed: post-traumatic scarring of the soft tissues of the right groin, inner surface of the right thigh, buttocks, right inguinal canal of the penis and scrotum, deformation of the cavernous cavity, normal indicators of cavernous blood circulation. In the early postoperative period (2 months after the intervention), the patient indicated satisfaction with the cosmetic and functional results, the preservation of morning erections, moderate discomfort in the penis during erection. Prosthetics of the right testicle are planned. The clinical case once again confirms the need for qualified surgical care during the first “golden” hour and subsequent phased treatment at a specialized level using the VAC therapy system in patients with gunshot wounds and large soft tissue defects. The experience of military medicine demonstrates the importance of involving specialists of various profiles in the treatment of combined gunshot wounds of the pelvis. An important stage of treatment in the wounded is plastic and reconstructive surgery in the long term, which is aimed at improving the functional, cosmetic and psychological results of treatment.

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ENCAPSULATION OF METALLIC SOFT-TISSUE FOREIGN BODIES WITH A LONG CARRIER LIFE

Kharkiv Surgical School ◽

10.37699/2308-7005.1.2020.27 ◽

2020 ◽

pp. 160-164

Author(s):

V. V. Negoduyko ◽

R. M. Mikhailusov ◽

T. P. Yakimova ◽

P. M. Zamyatin ◽

S. O. Beresnev ◽

...

Keyword(s):

Foreign Body ◽

Soft Tissue ◽

Foreign Bodies ◽

Soft Tissues ◽

Clinical Laboratory ◽

Gunshot Wounds ◽

Analysis Data ◽

Capsule Formation ◽

Iron And Steel ◽

Morphological Studies

Sumary. The aim is to investigate the features of pathogenesis in capsule formation around metallic foreign bodies of soft tissues. Materials and methods. The results of a study of 6 patients with metallic foreign bodies of soft tissues with a carrier period of 16 to 50 years were analyzed. 3 injured had foreign bodies of gunshot origin and 3 patients had foreign bodies as a result of personal injury. Used clinical, laboratory, instrumental, histological, immunohistochemical, X-ray spectrometric studies. Results. All foreign soft tissue bodies were removed with the capsule. By gender: 5 men and 1 woman. By localization - the lower extremity. Pain was present in all the victims. Radiography and ultrasound were informative, magnetodetection is informative only at the superficial location of a foreign body. The foreign bodies were made of gray cast iron and steel needle wire. Histologically, immunohistochemically and radiospectrometrically, it has been found that the capsule formation around the foreign body is affected by the mechanism and extent of damage to the soft tissues, the composition of the metal and its coating, and the carrier term of the foreign body. Conclusions. Depending on the composition of the metal and its coating, there is a different rate of oxidation of the foreign body in the soft tissues: oxidation of metal foreign bodies of fire origin is faster. The formation of the capsule around the foreign body is affected by the mechanism of tissue damage: when the needle penetrates, the soft tissues are destroyed minimally, in the case of gunshot wounds, they are destroyed more. Spectral analysis data in conjunction with morphological studies are the basis for the removal of a foreign body of inflammatory origin along with the capsule.

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

Kharkiv Surgical School ◽

10.37699/2308-7005.3.2021.09 ◽

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.

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ON FOREIGN BODIES IN THE BLADDER RESULTING FROM GUNSHOT WOUNDS.

The Lancet ◽

10.1016/s0140-6736(01)14700-8 ◽

1916 ◽

Vol 187 (4836) ◽

pp. 958-959 ◽

Cited By ~ 2

Author(s):

G.Grey Turner

Keyword(s):

Foreign Bodies ◽

Gunshot Wounds

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A Rare Case of Chronic Intracerebral Foreign Body

Green Medical Journal ◽

10.33096/gmj.v2i1.34 ◽

2020 ◽

Vol 2 (1) ◽

pp. 18-23

Author(s):

Naufal Hilmy Imran ◽

Wahyudi

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Gunshot Wounds ◽

Anatomical Location ◽

Major Injury ◽

Left Limb ◽

Foreign Body Extraction ◽

History Of ◽

Motor Strength ◽

The Right

Introduction: Intracranial foreign bodies are usually caused by trauma that penetrates the cranium. Gunshot wounds are the most common cause, while non-missile intracranial penetration is rare. The patient’s clinical condition highly depends on the mechanism, anatomical location of the lesion, and related injuries. Possible complications include intracerebral hemorrhage, contusion, major injury on the vascular, and meningitis. In this article, we report case of intracerebral nail extraction from a patient with right cerebral foreign body. Case presentation: A 22-year-old man with a history of unspecified schizophrenia reported with reduced awareness accompanied by weakness of his left limb. During a head CT scan of the head, there are several tubular foreign bodies in the right cerebral. Craniotomy for foreign body extraction and drainage of the cerebral abscess is immediately performed. Four days after surgery, the patient had increased awareness, although there was no significant improvement in motor strength. One month after discharged from hospital there was slight improvement in motor strength. Conclusion: Extraction of foreign bodies by a surgical procedure is mandatory and should be performed thoroughly. The administration of antibiotics, anticonvulsants, physiotherapy, and psychiatric follow-up should be added to the treatment of this patient.

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