CLINICAL SIGNS OF INTERACTION OF A FERROMAGNETIC FOREIGN BODY WITH A SURGICAL MAGNETIC INSTRUMENT

Abstract. The goal is to demonstrate the features of clinical diagnosis and removal of ferromagnetic foreign bodies of firearm origin of various localization. Materials and methods. All the patients who were studied had gunshot wounds of different localization, were examined, anamnesis was studied, X-rays were performed by various methods and, according to indications, they were operated on the basis of the Military Medical Clinical Center of the Northern Region. Depending on the applied methods of diagnosis and removal of foreign bodies, the wounded were divided into two groups: 528 (50.5%) injuries to soft tissues and 518 (49.5%) injuries to internal organs. The age of the injured ranged from 19 to 59 years and was 31.7±0.26 years on average. Among the wounded, men of the most working age (20-49 years) prevail. According to the etiological factor, gunshot wound (62.4%), bullet wound (3.6%), explosive wound (32.4%), shrapnel and bullet wound simultaneously (1.5%). Mandatory research method was magnetodetection, clinical signs of the interaction of a magnetic tool and a ferromagnetic foreign body in human tissues are described in this work. In this work, magnetic tools from small, large and endoscopic sets and household magnets from the last 10 years were used. The results. When a magnet interacts with a ferromagnetic metal foreign body in soft tissues, a number of effects occur: sticking, sailing, hanging, clicking, slipping. The frequency of visual direct signs is as follows: sticking effect – (20.1±1.3)%, sail effect – (24.7±1.4)%, hovering effect – (16.4±1.2)%, sliding effect – (8.4±0.9)%, click effect – (34.3±1.5)%. The frequency of increased pain syndrome at the location of the metal ferromagnetic foreign body when the magnetic tool approaches the foreign body is (12.1±1.2) %. Disturbance of the heart rhythm in the form of extrasystole during magnetodetection of the diaphragm in the presence of a ferromagnetic foreign body in the right ventricle of the heart, which got there during vascular migration, was observed in one case. Features of the interaction of modern magnetic surgical instruments and a ferromagnetic foreign body in tissues is the distance between the tool and the foreign body. Conclusions. Clinical signs of the interaction of modern magnetic surgical instruments are diverse and depend on the contact distance. Direct visual signs of the interaction of a ferromagnetic foreign body with a magnetic surgical instrument are visualized in the form of effects: sticking, sailing, hanging, clicking, slipping. Indirect signs of the interaction of a ferromagnetic foreign body with a magnetic surgical instrument are manifested in the form of increased pain syndrome at the location of the foreign body and heart rhythm disturbances when the foreign body is located in the heart.