RU2313294C1 - Method for removing foreign body from soft tissues of organism - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves making staining preparation injection through soft tissues into foreign body disposition zone and into injection canal in return movement of the injection needle. Skin, subcutaneous cellular tissue, fascia are cut layer-by-layer. Muscle tissue fibers are drawn apart along the stained injection canal direction to the localized foreign body.

EFFECT: high accuracy in determining foreign body location; reduced risk of traumatic complications; accelerated surgical intervention.

2 cl, 1 dwg

Description

The invention relates to medicine, namely to surgery and traumatology, and can be used in the surgical treatment of fragmentation and bullet wounds, in particular, in operations to extract solid foreign bodies of small sizes located in the soft tissues of the body.

A known method of removing a foreign body of a small size located in the soft tissues of the body, performing a surgical operation, including layer-by-layer dissection of the skin, subcutaneous tissue, fascia, dilution along the fibers of muscle tissue to the location of the foreign body. (Manual on field surgery for army medical services, Military Publishing House of the Ministry of Defense of the USSR, M, 1981, pp. 26-30). Moreover, it is extremely important for the choice of tactics for conducting a surgical operation to determine the exact location of a foreign body, for example, by fluoroscopic, and / or ultrasound, and / or tomographic examination. In the future, the implementation of a surgical operation in the projection of finding a foreign body. The accuracy of determining the location of a foreign body and its intraoperative search depends both on the error of the available equipment and on the qualifications and experience of the surgeon, and these factors negatively affect the duration and invasiveness of a surgical operation.

The objective of the invention is to reduce surgical trauma and reduce the time of the operation to remove a foreign body from the soft tissues.

The technical result is to increase the accuracy of determining the location of a foreign body to be surgically removed from the soft tissues of the body and the shortest expected path of dissection of soft tissues to it.

This is achieved by the fact that when implementing the known method of removing a foreign body from the soft tissues of the body, including layer-by-layer dissection of the skin, subcutaneous tissue, fascia, dilution of muscle tissue fibers to the location of the foreign body, preliminarily during ultrasound, and / or tomographic, and / or fluoroscopic examination localization of the proposed dissection path to the location of the foreign body is carried out, which is carried out by injecting a dye preparation into the zone through soft tissues estonahozhdeniya foreign body in the injection channel during the return stroke of the injection needle, and then layering a cut skin, subcutaneous tissue, fascia, muscle fibers dilution performed during the injection of the colored channel to localized foreign body. With the above localization of the proposed path from the skin surface to a foreign body, a contrasted "path" is formed in the soft tissues. As a coloring preparation, preparations prepared by diluting 1: 11% alcohol solution of brilliant green and 2% lidocaine, as well as 1% alcohol solution of methylene blue and 2% lidocaine solution can be used. During the operation, dissection of the skin, subcutaneous tissue, fascia, dilution along the muscle tissue fibers to the location of the foreign body is carried out along the contrasted “path”, which is usually the shortest path to the location of the foreign body, and, as a result, causing lesser operational injury the wounded.

Example

Patient V., born in 1973, was hospitalized in the thoracic department of the State Health Institution "Clinical Hospital №1" (inpatient card No. 186) from 10.01.2006 with a diagnosis of a condition after a gunshot wound to the chest, lumbar region. Foreign body of the soft tissues of the lumbar region. After preoperative preparation on January 13, 2006, a surgical operation was performed - removal of a foreign body of the lumbar region under endotracheal anesthesia. Immediately before the operation, a lumbar fluoroscopy was performed to determine the localization of the foreign body and to puncture it with the injection of a contrast agent into the injection channel while removing the needle (a preparation prepared by diluting 1: 1 with a 1% alcohol solution of brilliant green and 2% lidocaine). Foreign body - a bullet with dimensions: length 2.3 cm, diameter 3 mm, was in soft tissues at a depth of 7-8 cm from the skin of the transverse process 3 of the lumbar vertebra. The postoperative period was uneventful. An example implementation of the method is shown in the drawing.

The proposed method was used in patients with gunshot wounds of the soft tissues of the lumbar region, anterior abdominal wall, chest (6 cases in total). The postoperative period in all cases proceeded without complications.

Thus, the inventive method of removing solid foreign bodies from the soft tissues of the body can reduce the size of the surgical wound, and as a result, reduce the likelihood of postoperative complications, speed up the rehabilitation of the patient, and also reduce the time of the surgery, and accordingly, the toxic effects of anesthesia.

Claims (2)

1. A method of removing a foreign body from the soft tissues of the body, including layer-by-layer dissection of the skin, subcutaneous tissue, fascia, dilution of muscle tissue fibers to the location of the foreign body, characterized in that prior to ultrasound, and / or tomographic and / or fluoroscopic examination, localization is performed the shortest way to the location of a foreign body, which is carried out by injection through the soft tissues of a dye preparation in the area of the foreign body and in the injection channel the reverse course of the injection needle, then a layer-by-layer dissection of the skin, subcutaneous tissue, fascia is performed, the dilution of muscle tissue fibers is performed along the colored injection channel to a localized foreign body. 2. The method according to claim 1, characterized in that the composition containing the mixture of a 2% solution of lidocaine with a 1% alcohol solution of brilliant green or a solution of methylene blue in a ratio of 1: 1 is used as a coloring preparation.

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