Koval Aleksej Nikolaevich (RU),Коваль Алексей Николаевич (RU),Melkonyan Gegam Genrikovich (RU),Мелконян Гегам Генрикович (RU),Romanov Valentin Evgenevich (RU),Романов Валентин Евгеньевич (RU),Bulavino,Булавинов Сергей Николаевич (RU),Рачковский Игорь Васильевич (RU),Коваль Ольга Анатольевна (RU),Стрельник
申请号：
RU2016105124
公开号：
RU0002632517C9
申请日:
2016.02.16
申请国别(地区):
RU
年份:
2017
代理人:
摘要：
FIELD: medicine.SUBSTANCE: ultrasonic and X-ray examination with metal grids of various sizes are used for non-invasive detection of a radiographic contrast foreign body. For this purpose, several stages are performed in sequence. After determining the depth of the foreign body, an exact projection onto the skin of the foreign body is applied. At the second stage, a decision to remove the foreign body is made taking into account the indications and contraindications to the surgical intervention. At the third stage, the method of anesthesia is chosen taking into account the size, depth and localization of the foreign body. At the fourth stage, an additional parallel duplicating marking of the foreign body projection is applied to the skin with a permanent marker. The line of the most rational surgical approach is chosen and applied. At the fifth stage, with the obligatory participation of the second surgeon, the standard initial approach of a certain length is performed on the applied marking: for the hand and foot 1-1.5 cm, for the forearm, shoulder, shin - 1.5-2.5 cm, for the thigh and gluteal region - 2.5-3 cm, which is performed strictly perpendicular to the surface of the skin, with a strictly vertical advance to a pre-known depth controlled by parts of surgical instruments with a standard length. In this case, the search of a foreign body is carried out using a number of techniques: assessing the condition of the tissues adjacent to the wound to detect signs of metallosis, probing the tissues with the close Billroth's hemostatic forceps with visual control until the sensation of "scratching" appears, examining the wound with a finger, during which it is possible to feel the foreign body, creating an anti-support by the operator's arm in the circumference of the wound, which creates conditions for the palpation of the foreign body, or it's spontaneous exit into the wound and removal of the detected foreign body with a dissection forceps which ensures the exact c
