REMOVAL OF METAL FRAGMENTS FROM MINE-EXPLOSIVE INJURIES UNDER ANGIOGRAPHIC CONTROL

Summary. Objective. Mine and explosive injuries are a serious problem of military conflicts and terrorist acts. Since the full-scale military invasion of the Russian Federation in Ukraine, the problem of treating mine-explosive wounds with the presence of metal fragments is an extremely important and urgent medical problem. Victims often receive multiple shrapnel injuries, which lead to serious consequences and complications. The duration of treatment for shrapnel wounds can vary significantly depending on the severity of the damage, infectious complications, and the timeliness of shrapnel removal. Materials and methods. The study is based on the analysis of the results of the treatment of 72 wounded with mine-explosive injuries with the presence of metal fragments, which got the hospital treatment at GI “V.T. Zaycev Institute of General and Urgent Surgery of NAMS of Ukraine” from 2022 to 2024, aged 18 to 72 years. Results and discussion. Active surgical tactics with removal of soft tissue fragments were used in all wounded: under angiographic control in 40 wounded (55,6%), video thoracoscopic or video laparoscopic in 17 wounded (23,6%), laparotomy access in 8 wounded (11,1%) and after thoraco-sternotomy with the use of magnets in 7 wounded (9,7%). Successful removal of debris was performed in 70 (97,2%) of the wounded. Specific postoperative complications were not noted in any case, 3 (4,2%) wounded patients developed seromas of postoperative wounds after thoracotomy. Conclusion. 1. 1. In 40 (55,6%) wounded, the removal of debris under angiographic control was effective. In addition to angiographic control, endoscopic visualization with debris extraction was used in 3 (4,2%) injured patients. 2. In 2 wounded (2,8%) after the puncture tracing of the fragment, a decision was made to leave them in view of the stability of the fragments in accordance with the developed classification, as well as in connection with the high traumatic nature of the necessary access. 3. The average duration of treatment until complete healing of wounds was 21,4 bed-days.