USE OF INTRAOPERATIVE ULTRASONIC NAVIGATION IN THE TREATMENT OF SHRAPNEL WOUNDS OF SOFT TISSUES

The aim: to improve the e—ectiveness of the surgical treatment of patients with foreign bodies in soft tissues using intraoperative ultrasound guidance. Materials and methods. A prospective single-center case-control study was conducted. A total of 247 patients with shrapnel and gunshot wounds were treated during the period 2021–2023. All patients were divided into group No. 1 - 189 patients operated under ultrasound guidance, group No. 2 - 23 patients treated in the surgical department using standard surgical techniques, and group No. 3 - 35 patients treated according to the recommendations of the International Committee of the Red Cross (foreign bodies were not removed). The results showed that the shortest duration of hospitalization was observed in group 1, amounting to 3.2±1.1 days. In groups 2 and 3, this indicator was signi†cantly higher: 8.4±3.1 and 18.7±5.1 days, respectively (p≤0.05). A similar trend was observed in the duration of outpatient treatment, which was minimal in group 1 (14.2±4.3 days) compared to groups 2 (23.4±2.1 days) and 3 (38.3±2.2 days) (p≤0.05). The complications were recorded in 8 patients in group 2 and 15 in group 3. The average duration of the procedure for removing foreign bodies under ultrasound guidance (group 1) was 12.2±2.2 minutes, which is much less than using a standard surgical methodology (61.6±4.5 minutes) (p≤0.05). The length of the surgical section in group 1 on average was 1.5±0.3 cm, while in groups with standard methods - 6.4±1.1 cm (p≤0.05). In the control group (group 3) 42.8% of patients (15 people) developed complications associated with retained foreign body in the wound. Conclusion. Comparison of the outcomes of treating the wounded using ultrasound-guided extraction of foreign bodies and traditional approaches demonstrated signi†cant advantages of ultrasound navigation. This approach helped to signi†cantly optimize and simplify the procedure for extracting fragments, as well as reduce the period of hospitalization of patients and outpatient treatment.