Nehoduiko V. Diagnostic and removing foreign bodies of soft tissues of a gun origin (experimental and clinical research

The dissertation is devoted to the problem of increasing the effectiveness of diagnosis and surgical treatment of wounded with injuries in the presence of foreign bodies of soft tissues of origin. On the basis of complex clinical and experimental research and analysis of cause and effect factors of fire damage, a number of etiopathogenetic directions of diagnosis and surgical treatment of victims with foreign bodies of soft tissues are proposed. The author carried out a comprehensive analysis of 1046 wounded of foreign bodies of soft tissues firearms and experimental simulation of such injuries. It was noted that the main injuries during a fire-fighting trauma were received due to fragmentation wounds - in (94,8±0,7)%, bullets - (3,6±0,6)%, combined balloons + fragmentary wounds - in (1,5±0,4)% of cases. In this case, the presence of foreign bodies in soft tissues of different localization was 3690. In the study of the effect of experimental gunshot trauma on the ultrastructure of semiphrases of laboratory animals, the development of destructive changes of submicroscopic architectonics has been established. The developed differentiated diagnostic and surgical tactics with the use of modern technologies allowed to reduce the number of complications by 2 times (P <0,05). The dissertation highlights new approaches in the decision of the scientific problem of fighting fire injury, which involves reducing the number of complications by improving the results of surgical treatment of the wounded with the presence of foreign bodies of soft tissues on the basis of a developed set of diagnostic, treatment and preventive measures. The concept of this study is to develop from the standpoint of the systematic approach of modern priority directions of surgical treatment of the wounded with fire and blast-explosive trauma in accordance with the peculiarities and pathogenetic patterns of the course of the early and late post-war periods, the informativeness of the signs and criteria of prediction of the exits, which led to a decrease in the number of complications, to reduce medium-term treatment and quality of life. The basis of the concept is the conceptual model of structural and metabolic mechanisms for the formation of dysfunctional disorders in the process of soft tissue remodeling with the presence of extraneous bodies and a comprehensive approach to diagnosis, surgical treatment and prevention with the use of newly developed instruments in wounded with various fire injuries and devices, methods and technologies.