Healing features of experimental injuries of soft tissues that contain foreign bodies in the form of fragments of military personnel uniforms.

INTRODUCTION: The healing of combat wounds can be complicated by the presence of foreign bodies. The present research aimed to study the regeneration of soft tissue injuries complicated by foreign bodies in the form of fragments of military uniforms. METHODS: 60 rats were divided into four groups: intact (Int), control (Con) and two experimental (EG1, EG2). In Con, wounds were sutured without implantation of foreign bodies. A uniform consisting of 100% cotton was used as foreign bodies for EG1 and a uniform consisting of 65% cotton and 35% polyester for EG2. Histological studies were performed according to generally accepted methods. The growth factors wеre determined by ELISA. RESULTS: In EG1, the inflammatory reaction proceeded protractedly, which complicated the development of granulation tissue. In EG2, considering the moderate inflammatory reactions, healing of the wounds became possible. The increase of the growth factors content in Con was maximal at the 15th day: basic fibroblast growth factor (bFGF)-2.2 times and vascular endothelial growth factor (VEGF)-1.6 times (p<0.001). In experimental groups, the bFGF content was maximal at the 60th day and exceeded the normal values by 1.7 times in EG1 and by 2.6 times in EG2 (p<0.001); the level of VEGF was slightly higher than that in healthy animals. CONCLUSIONS: The study showed wound healing in all groups. The repair of injuries in rats of EG1 and EG2 was complicated by the textile implant and took longer. The dynamics of the content of growth factors reflected the impairment of wound healing processes. These violations were more pronounced in the EG1 group.

DYNAMICS OF ULTRASTRUCTURAL REARRANGEMENTS OF SKELETAL MUSCLE FIBROBLASTS AFTER SIMULATED GUNSHOT SHRAPNEL WOUNDS.

Purpose of the study the peculiarities of rearrangements of skeletal muscle fibroblasts surrounding the wound canal at various times after an experimentally modeled gunshot shrapnel wounds. Experimental modeling of gunshot shrapnel wounds of soft tissues has been carried out on 20 laboratory animals - breeding rabbits of the breed «Chinchilla¼. To laboratory animal was caused a gunshot wound in the sartorius area with the gun «Fort-12¼ caliber 9 mm. The initial velocity of the fragment was 305 m/s. Ultrathin muscle sections were examined using an EM-125 electron microscope at accelerating voltage of 75 kV, with a magnification of 20000 - 60000 arm. In an experiment it was revealed that on the thirtieth day most of the fibroblasts of the wound canal in the femoral muscle tissue had an ultrastructure characteristic of the course of compensatory-adaptive, synthetic, and reparative processes. Sixty days after a gunshot wound, the submicroscopic organization of fibroblasts from the wound canal area undergoes disorders associated with a decrease in the synthetic activity of fibroblasts.

[DYNAMICS OF CHANGES IN THE MACROSTRUCTURE OF MACROPHAGE CELLS OF THE WOUND CHANNEL AFTER A GUNSHOT WOUND].

The purpose of this study was to identify the features of skeletal muscle macrophagocytic submicroscopic architectonics, the dynamics of transformations of organelles and intracellular membranes at different time after the simulated gunshot wound. The study involved 26 breeding rabbits. Gunshot wounds were inflicted from a Fort 12 pistol. Rabbits were removed from the experiment on the 30th and 60th day, after the application of wounds. Ultrathin sections, after contrasting with lead citrate, were examined under an EM-125 electron microscope at an accelerating voltage of 75 kV, with an increase of 42,000-72,000. Electronic microscopic studies of macrophagocyte organelles taken from the scar tissue of the wound channel on the thirtieth day after a gunshot wound revealed a large number of macrophage cells that are in a state of high functional activity, dystrophic and destructive changes of organelles with focal disruption of the membrane of the nucleus, mitochondria and the granular endoplasmatic reticulum reticulation. The course of catabolic processes caused by the presence in the wound channel of toxic components, destroyed myosymplasts and heavy metal ions of the damaging element. On the sixtieth day after a gunshot wound, the increased activity of macrophage cells remained, due to sluggish current processes of utilization of the destroyed ultrastructural components of myosymplasts and heavy metal ions from the damaging element.

RESEARCH OF FOREIGN BODIES SOFT TISSUE GUNSHOT ORIGIN.

The purpose of the study was to analyze the elemental, quantitative, and qualitative composition of foreign bodies of a firearm origin removed from the soft tissues of military personnel during a limited military conflict in Ukraine, as well as to investigate the phase composition and structural characteristics of metallic foreign bodies having ferromagnetic properties. The elemental, quantitative, and qualitative composition of 3690 identified and 1928 removed foreign bodies of soft tissues of gunshot origin, identified in 1046 wounded, was analyzed. After removal from the soft tissues, the following foreign bodies were identified: metal - 1600 (83%), wood - 8 (0.4%), plastic - 10 (0.5%), rubber - 4 (0.2%), organic (soil, leaves, grass) - 68 (3.5%), parts of concrete - 8 (0.4%), parts of clothing - 224 (11.6%), glass - 6 (0.3%). Among metal foreign bodies, ferromagnetic ones made up 1542 (96.4%) cases, non-magnetic ones - 58 (3.6%). Ferromagnetic foreign bodies interact strongly with permanent magnets. The development and practical application of new special surgical instruments using permanent magnets that will simplify the diagnosis, search and removal of foreign bodies of fire origin is advisable.

[RESULTS OF SURGICAL MAGNETIC INSTRUMENTS APPLICATION FOR SURVEY OF WOUNDS AND REMOVAL OF FERROMAGNETIC FOREIGN BODIES].

The results of the developed set of magnetic surgical instruments for measuring parameters and testing wounds, diagnosis and removal of metallic ferromagnetic foreign bodies were analysed. Is a description of tools and devices, technologies used for the diagnosis and removal of metallic ferromagnetic foreign bodies. Using a magnetic surgical instruments for gunshot wounds has improved the quality of diagnosis and treatment outcomes.