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

Data on the possibility of using ultrasound diagnostics when removing foreign bodies - bullets and fragments from body tissues during primary or repeated surgical treatment are rather limited. The aim of the research – improving the results of treatment of victims with gunshot fragmentation and bullet wounds by using a complex of ultrasound and X-ray navigation in the process of removing injurious elements during primary and repeated surgical treatment. The study included 214 wounded. In group I, the main group (122 wounded), the removal of fragments was carried out using a complex of X-ray and ultrasound navigation. In group II, the control group (92 wounded), only X-ray navigation was used. In group I during primary surgical treatment, foreign objects were removed in 101 (82.8%) of 122 injured and during secondary – in 17 (13.9%). In group 4 (3.3%) patients, the fragments were not visualized: in 1 - in the lateral region of the neck, in 1 - in the muscles of the leg, in 2 - in the chest wall. Complications were not observed. In group II, during primary surgical treatment, foreign objects were removed in 59 (64.1%), and in the secondary – in 18 (19.6%). The reasons for the failures were: deep lieying of fragments - in 6 (6.5%), location near large vessels - in 5 (5.4%), non-X-ray contrast foreign bodies - in 4 (4.3%). Among the complications, bleeding was observed in 2 wounded. The use of ultrasound navigation allows by 18.7% to increase the frequency of detection and removal of foreign bodies - bullets and fragments during the primary surgical treatment of a wound and to reduce the need for repeated interventions by 5.7%. The advantages of the method are: mobility, high information content in structural damages to soft tissues and verification of foreign bodies, the possibility of performing real-time, the absence of exposure to radiation

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

Data on the possibility of using ultrasound diagnostics when removing foreign bodies - bullets and fragments from body tissues during primary or repeated surgical treatment are rather limited. The aim of the research – improving the results of treatment of victims with gunshot fragmentation and bullet wounds by using a complex of ultrasound and X-ray navigation in the process of removing injurious elements during primary and repeated surgical treatment. The study included 214 wounded. In group I, the main group (122 wounded), the removal of fragments was carried out using a complex of X-ray and ultrasound navigation. In group II, the control group (92 wounded), only X-ray navigation was used. In group I during primary surgical treatment, foreign objects were removed in 101 (82.8%) of 122 injured and during secondary – in 17 (13.9%). In group 4 (3.3%) patients, the fragments were not visualized: in 1 - in the lateral region of the neck, in 1 - in the muscles of the leg, in 2 - in the chest wall. Complications were not observed. In group II, during primary surgical treatment, foreign objects were removed in 59 (64.1%), and in the secondary – in 18 (19.6%). The reasons for the failures were: deep lieying of fragments - in 6 (6.5%), location near large vessels - in 5 (5.4%), non-X-ray contrast foreign bodies - in 4 (4.3%). Among the complications, bleeding was observed in 2 wounded. The use of ultrasound navigation allows by 18.7% to increase the frequency of detection and removal of foreign bodies - bullets and fragments during the primary surgical treatment of a wound and to reduce the need for repeated interventions by 5.7%. The advantages of the method are: mobility, high information content in structural damages to soft tissues and verification of foreign bodies, the possibility of performing real-time, the absence of exposure to radiation

Особливості хірургічного лікування вогнепальних поранень живота

Особливості хірургічного лікування вогнепальних поранень живот

Postnonclassical methodology — psychosynergetics: possibility of using in medicine

У даній статті в термінах психосинергетики розглянуто класичний випадок з дифузно-аксональним ушкодженням головного мозку, яке сформувало апалічний синдром і призвело до вегетативного стану дитини 2000 р. народження. Докладно описується лікування із застосуванням авторської методики «Альфалогічна нейром’язова реабілітація» за методом «Створююча Сила» професора І. В. Єршової-Бабенко, спрямованої на реабілітацію людей із наслідками черепно-мозкової травми.The article deals with a clinical case of diffuse axonal injury of the brain, which formed the apallitical syndrome and caused the vegetative state of a child born in 2000 year. Treatment supplemented with the usage of the author’s method “Alfalogical neuromuscular rehabilitation” according to the method of “Creating Power” by professor I. V. Yershova-Babenko, directed to rehabilitation of people with the consequences of traumatic brain injury is described in details

Application of videolaparoscopy in a field military hospital

В мобильном госпитале в полевых условиях у 62 пациентов выполнены видеоэндоскопические операции по поводу различных повреждений и заболеваний органов брюшной полости. Это позволило у 20 пострадавших избежать выполнения напрасной лапаротомии. У 11 из них устранены повреждения, в том числе у 3 — при сочетанных ранениях груди и живота, у 6 — изолированном ранении живота. Диагностическая лапароскопия выполнена у 5 пострадавших при закрытой травме живота и сомнительных результатах лапароцентеза, у 6 — при непроникающих огнестрельных ранениях. При массовом поступлении раненых возможности лечебной лапароскопии ограничены.In a mobile hospital whilw a field conditions videoendoscopic operations for various damages of abdominal organs and diseases were performed in 62 patients. This have permitted to avoid performance of ineffective laparotomy in 20 injured persons. In 11 of them the injuries were repaired, including in 3 — while thoraco—abdominal woundings present, and in 6 — in isolated abdominal wounding. Diagnostic laparoscopy was performed in 5injured persons, suffering closed abdominal trauma and doubtful results of laparocentesis, and in 6 — in nonpenetrating gun—shot woundings. In a mass admittance of the wounded patients the treatment laparoscopy possibilities are restricted

Peculiarities of surgical treatment of the abdominal gun–shot woundings

У структурі сучасної бойової травми зростає частка пошкоджень органів черевної порожнини, які супроводжуються розвитком травматичного шоку, поліорганної недостатності та високою летальністю. Трирічний досвід збройного конфлікту на сході України показав, що сучасна зброя – реактивні системи залпового вогню, касетні бомби, керовані вибухові пристрої високоточної дії тощо – завдає особливо тяжких поранень. Структура бойової травми живота залежить від характеру ведення бойових дій, який останніми роками також значно змінився, тому потрібні нові підходи до діагностичних заходів та хірургічного лікування

Surgical treatment of infiltrative forms of colorectal endometriosis

Background. Deep infiltrative endometriosis is a relevant and complex medical and social problem of nowadays. The most common location of deep forms of endometriosis is the intestine, which occurs in 5-37% of patients. Deep infiltrative intestinal endometriosis is the most aggressive form of endometriosis, and is characterized by a number of multifunctional disorders. The aim of the study. Improving the results of surgical treatment of patients with colorectal endometriosis. Materials and methods. We conducted a retro-prospective non-randomized study of cases of surgical treatment of 47 (100%) patients with colorectal endometriosis in the period of 2015-2020 on the basis of the University Clinic of Odessa National Medical University. The age of the patients ranged from 19 to 43 years. Clinical cases of endometriosis were confirmed by histological findings. Multimodal tactics were used in the diagnosis of endometriosis, using a potential of non-invasive and invasive methods. Evaluation of diagnostic data and choice of surgical tactics were used according to the criteria of M.Abrao

Treatment of purulent complications of soft tissues’ gunshot wounds

According to the military operations in the east ofUkraine, the treatment of gunshot wounds became an extremely important problem. The wounded persons need comprehensive treatment using modern approaches one of which is vacuum wound therapy combined with other factors influencing the gunshot wound. A comparative analysis of the complex treatment efficacy of 80 wounded with trunk both soft and an extremities injury was carried out. Complex surgical treatment of wounded with soft tissue’s gunshot wounds purulent complications accelerates the wounds recovery by 1.8 times which allows to shorten significantly the terms of treatment and rehabilitation of the wounded and is an important criterion for determining the effectiveness of the developed technique of complex treatment of soft-tissue gunshot wounds. The use of pulsed negative pressure in the 12 kPa mode in the purulent soft tissue’s wounds complex treatment affected the rate of microflora elimination in the focus of infection and ensured the reduction of the total number of bacteria in the wounds on the 11th day of treatment. Under these conditions, normalization of the main parameters of the peripheral blood, pathobiochemical correlates of the inflammatory process is noted, and also the terms of treatment of blind, through and superficial (tangential) wounds for wounded servicemen are significantly reduced. The proposed treatment program can reduce the severity of the pain syndrome and prevent the further development of gunshot wounds complications

Endovideosurgical technologies in diagnosis and surgical treatment of combat abdominal injury

The aim of the study was to improve the results of treatment of the wounded with combat abdominal trauma at the expense of the improved system of diagnosis using pulse oximetry, FAST-protocol and surgical treatment applying endovideosurgical technologies

Application of endovideosurgical technologies in the treatment of ventral herniations after gunshot wounds of the abdomen

Gunshot wounds of the abdomen are often accompanied bya significant destruction of the abdominal cavity with the developmentof peritonitis, and in the future - various complications (failure of anastomoses, abscess formation, repeated bleeding, etc.), which requires repeated surgical interventions, and as a consequence - the formation of postoperative ventral hernias. The aim of the study is to improve the results of surgical treatment of ventral hernias after gunshot wounds of the abdomen due to the use of laparoscopic techniques. The analysis of treatment of 21 patients with postoperative ventral hernias formed as a result of operations concerning gunshot wounds of the abdomen was carried out. 14 wounded suffered one operation on the abdominal organs in the past (66.7%), 5 - two operations (23.8%), 1 - three operations (4.8%), 1 - five operations (4.8%). The dimensions of the hernial gates and the risk of recurrence were determined according to the SWE classification: W1 - 9 patients (42.9%), W2 - 8 (38.1%), W3 - (9.5%), W4 - 2 (9.5%). The third patients underwent laparoscopic allogernioplasty according to the IROM technique with a Teflon allograft, which was fixed in 2 cases with the help of a hernostepler, in the 1 st - with transdermal separate seams with Teflon filament. Complications after laparoscopic operations were not. The use of laparoscopic techniques can significantly reduce bed-day, avoid the development of abdominal compartment syndrome, previously to activate the patient. Laparoscopic allogernioplasty according to the method of IPOM by the Teflon graft is considered to be the operation of choice.</pre