Shypilov S. Improving the methods of diagnosis and surgical treatment of the wounded with the diaphragm gunshot injuries

The study is based on the analysis of the results of the examination and treatment of 117 wounded with a diaphragm combat trauma. For the first time, the proportion of gunshot damage to the diaphragm in the structure of combat losses during the modern hybrid war has been determined. The data on the effectiveness of the application of FAST-protocol, videothoracoscopy with coherent monochromatic polarized narrow-spectrum imaging in the diagnosis of inflammatory diaphragm damage at the II-III levels of medical support in the conditions of hybrid war were obtained. It is proved that the use of an endoscopic magnetic tool developed in the clinic for the removal of foreign bodies from the pleural and abdominal cavity, an improved method of fluorescence diagnostics of soft tissues of the gunshot wound of the diaphragm, suturing of the gunshot wounds by the proposed endoscopic single-row upper apex pleats helps reduce the number of purulent-inflammatory complications and improve respiratory function. Keywords: the diaphragm gunshot injury; coherent, monochromatic, polarized narrow-spectrum visualization; magnetic detection; fluorescence diagnostics; thoracoscopic suturing of the diaphragm wounds.