Короткий опис (реферат):
The problem of gunshot wounds treatment is one of the urgent and incompletely
resolved issues of modern surgery. Diagnosis of gunshot wounds is currently not efficient
enough. There was a need to improve the content and scope of medical care with the
possibility of strengthening its diagnostic chain. The aim of the work is to substantiate
experimentally the feasibility and effectiveness of using diagnostic infrared thermometry in gunshot wounds of the soft tissues of the extremities. Experimental studies were performed
under the chronic experimental conditions on Shinshilla breed rabbits which were subjected to
gunshot wounds followed by laboratory, morphological and functional examination for 5
days. The animals were divided into 3 groups depending on the type of gunshot wound that
was inflicted. The animals were removed from the experiment by the introduction of
chloroethyl anesthesia on the 1st, 3rd and 5th days, after which the soft tissues with the capsule
surrounding the fragment were subjected to histological and electron microscopic
examination. On the 1st day of the study, a significant decrease in the diameter of the blood
vessels of the affected area was determined in the group of animals that were subject to injury
with firearms and metal fragments from the explosion of a grenade and an improvised
explosive device. It was in these groups that the highest mortality rate was registered. Under
the specified conditions of injury to the limbs of animals, as well as when injured by a
pneumatic weapon with a temperature of fragments of 100 oC, pronounced changes in pulse
and respiratory rate were noted. In further studies on rabbits on the 3rd and 5th days of the
experiment, the actual results did not differ from those obtained 24 hrs after injury. Those
rabbits that survived after the reproduction of various gunshot wounds had the greatest value.
The results of their thermometric measurements were evaluated in the dynamics of
experimental gunshot wounds and revealed the dependence of animal survival after gunshot
wounds on the temperature of the limb in the area of the wound.
There are the following leading criteria in favor of animals further survival after
gunshot wounds - the presence of a perforating vessel in the area surrounding the affected
space; the size of the diameter of the vessels in the adjacent area; no hemorrhage in the
muscle tissue located near the affected area; comparable with normal data of the functional
parameters of the animal's body – heart rate, blood oxygen pressure and respiration;
thermometry results. The limb thermometry has the important prognostic value after their
gunshot wound in terms of experimental animals survival. The correspondence of high
thermometry indexes after a gunshot wound vs the higher risk of an animal death is
statistically reliable and, accordingly, insignificant thermometric dynamics throughout the
experiment is in favor of a positive outcome after injury. It is extremely important to evaluate
thermometry data during the first 24 hours after receiving gunshot wounds, since we found
out the maximum validity of this method in the early time intervals. All this, with adequate
clinical testing and verification, has the most important medical prospects, aimed primarily at saving time for diagnostic measures and procedures. Thermometry allows to judge the activity and severity of connective tissue inflammation or sclerosis in the lesions of each
wound and provides the possibility of clinical application of remote thermography as a noninvasive method of diagnosis and prediction of complications in wounded with gunshot and explosives in various wounds.