Browsing by Author "Lurin, Igor"
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Item Computational modeling and analysis of wound formation in gunshot injuries(2023) Larin, Oleksiy; Tomashevskyi, Roman; Lurin, Igor; Gumeniuk, Kostyantyn; Nehoduiko, VolodymyrThis research aims to investigate the physical processes accompanying high-speed element penetration in gunshot wounds and understand the formation of wound channels, trajectory characteristics of bullets, and damaging effects on surrounding tissues. The study utilizes 3D computer modeling to simulate highspeed element penetration based on the 3D finite element method (FEM). The paper presents a methodology of computer simulation with mathematical basics and algorithmic descriptions. The approach uses direct explicit numerical integration over time for the impact of the metallic bullet into the gelatin block specimen that analyses within the framework of its plasticity considering the nonlinear pressure dependence in a shock wave. The algorithm of simulation incorporates the process of material destruction, where elements that reach critical strain values are removed from the model. The study provides insights into the behavior of different bullet types and their impact on tissue deformation from computational experiments that simulate the penetration into ballistic gelatin of two types of bullets, the 7H6M type, and the V-max type. The simulation results reveal the distribution of equivalent stresses in the wound channel at different moments in time. Additionally, the study analyses the penetration depth and diameter of the damaged material for both bullet types. The developed 3D computer modeling method can serve as a valuable tool for further investigations, facilitating the development of advanced medical treatments.Item Management of gunshot injury to the abdominal aorta and inferior vena cava: a case report of a combat patient wounded in the Russo-Ukrainian war(2024) Lurin, Igor; Khoroshun, Eduard; Makarov, Vitalii; Negoduyko, Volodymyr; Shypilov, Sergiy; Bunin, Yurii; Gorobeiko, Maksym; Dinets, AndriiBackground Russo-Ukrainian war is associated with severe traumas, including injuries to the major vessels. Penetrating aortic injury remains one of the most difficult injuries; the mortality rate is 90–100% in case of gunshot wounds, associated with frequent lethal outcomes due to uncontrolled bleeding. Of the three main abdominal veins, the inferior vena cava (IVC) is the most frequently damaged, which is required quick and appropriate surgical decisions to be made. Little is known about the management of gunshot injuries to such major vessels as the aorta and IVC. It is also worth mentioning about the importance to share our practical experience from the ongoing war for better understanding and future considerations by war surgeons of the vascular trauma management. The aim of the study was to demonstrate the specific features of the diagnosis and management of a gunshot shrapnel blind penetrating wound to the abdomen with injury to the aortic bifurcation level and the infrarenal section of the inferior vena cava. Case presentation A 44-year-old male soldier of the Armed Forces of Ukraine received a gunshot injury to the abdomen from a mortars’ explosive shelling. The patient was evacuated to the Forward Surgical Team (Role 1) and received primary surgical treatment within one hour after the injury according to the “golden hour” principle. Then, evacuated was performed to the Role 3 hospital in Kharkiv. At the Role 3 hospital, the patient underwent secondlook surgery as well as damage control surgery. At revision, no active bleeding was observed, and the surgical pads (packed previously by the Forward Surgical Team) were removed. Further revision showed a metal projectile within the aortic wall at the level of aortic bifurcation and wall defects were also detected for inferior vena cava. This metal projectile was removed by using the multifunctional surgical magnetic tool followed by suturing of the aortic wall defect as well as defects of the inferior vena cava. Conclusions Application of Damage Control Surgery is a useful approach in the management of severe vascular injury as well as useful to stop abdominal contamination by intestinal contents. The application of a surgical magnetic tool for the searching and removal of ferromagnetic foreign bodies reduces operative trauma and reduces the time for identification of foreign bodies.Item Methodology and use of experimental techniques in analyzing wound dynamics of penetrating injuries(2023) Tomashevskyi, Roman; Larin, Oleksiy; Kolisnyk, Kostyantyn; Zuev, Andrey; Gumeniuk, Kostyantyn; Lurin, Igor; Nehoduiko, VolodymyrThis research paper focuses on the experimental studies of the process of high-speed object penetration into human body simulators and the automated registration of physical phenomena parameters related with this process. It highlights the need for a comprehensive understanding of the physical processes involved and the challenges posed by the lack of biomedical information. It emphasizes the importance of studying the volume and characteristics of damage around the wound channel. The paper also proposes a methodology encompassing mathematical modeling, experimental studies using non-biological simulators, and data processing techniques to investigate wound dynamics. An experimental setup with a distributed information and measurement system is presented, enabling the collection and analysis of physical parameters during penetration impacts. The structure of a distributed information-measuring system has been developed that allows recording the parameters of physical processes that occur during the penetration of a high-speed object into the simulator. The issues of receiving and transmitting data from sensors using wireless communication channels are considered. The problem of synchronization of many distributed sensors, which is important for recording the parameters of short-term processes, is analyzed in detail. An example of obtaining data when launching a high-speed object into a simulator using an electric mass accelerator within the framework of the proposed system is given. The research aims to enhance medical practices, and protective equipment design, contributing to improved treatment outcomes and patient care.Item A new approach for reconstruction of the gunshot defect of the flexor surface of the ungual (distal) phalanx by the proper transverse branch of the digital artery: a case report of combat patient injured in the RussoUkrainian war(2023) Tertyshnyi, Serhii; Lurin, Igor; Khomenko, Igor; Gumeniuk, Kostiantyn; Shapovalov, Volodymyr; Nehoduiko, Volodymyr; Gorobeiko, Maksym; Dinets, AndriiItem Staged rehabilitation of military personnel as part of a multimodal approach to the gunshot soft tissue defects reconstruction(Acta Balneol. – 2023. - Vol. LXV, issue 5, part 177. – P. 291-297., 2023) Lurin, Igor; Khomenko, Igor; Gozhenko, Olena; Nehoduiko4, Volodymyr; Herasimenko, Oleh; Tertyshnyi, Serhii; Grigoriev, EvgenyAim: To increase the efficacy of the original staged scheme of wounded with soft tissues gunshot defects (STGD) rehabilitation using the original improvement of diagnostic and restorative rehabilitation measures. Materials and Methods: The wounded with STGD were admitted to the Military Medical Clinical Center of the Southern Region (Odesa). The wounded were randomized in three groups depending on the severity of the injury for further rehabilitation in sanatorium-resort conditions. Spectral infrared thermography diagnostic capabilities were used to control the efficacy of rehabilitation measures and to evaluate the rehabilitation prognosis. Results: The data obtained were divided into immediate clinical and delayed organizational ones with rapid implementation into the medical practice to support the military forces of Ukraine. Authors showed the full-fledged functional recovery of the patient’s injured limbs as a result of original step-by-step scheme applying of providing medical care in cases of STGD. Conclusions: Timely rehabilitation measures at all stages of providing medical care in the Armed Forces are faster and more effective. The organizational and methodological foundations of the staged rehabilitation system of wounded servicemen with STGD at different levels of medical care depending on the severity of the injury and the tactics of surgical treatment have been developed. Different three- and four-staged models of rehabilitation measures for the injured with different severity have been proposed.Item Surgery(ТОВ фірма «НТМТ», 2018) Boyko, Valeriy; Lisovyi, Volodymyr; Goncharenko, Ludmila; Taraban, Igor; Kryvoruchko, Igor; Kozin, Yuriy; Zamyatin, Petr; Grygorov, Yuriy; Makarov, Vitalii; Prasol, Vitaliy; Groma, Vasiliy; Yevtushenko, Denys; Sushkov, Sergey; Tolstanov, Oleksandr; Larin, Oleksandr; Lurin, Igor; Shafranskyi, Valeriy; Shcherbakov, Valeriy; Kuznetsov, Oleksandr; Smachilo, Rostislav; Mizhiritskaya, Nina; Ponomarev, Leonid; Makeev, Sergiy; Minukhin, Dmytro; Goloborodko, Mykola; Dotsenko, Dmitriy; Smolynik, Konstantin; Tokarev, Andriy; Avdosev, Yuriy; Gorbenko, Konstantyn; Tsodikov, Valentyn; Chernyayev, Mikita; Basylaishvili, Stanislav; Okley, DenysUkraine’s integration into the European community dictates the need to restructure higher education in the country in this direction and teaching at universities in Ukraine according to the principles of the Bologna Declaration, which will prepare young Ukrainian professionals compete with graduates of European and other institutions of higher education. In Kharkiv National Medical University is over-passage teachers of all disciplines, including surgery, for all courses on the principles of credit-modular system of training ESTS. Starting from the IV course, students learn surgery on the new model curriculum “Surgery”, which includes 5 modules, for students in higher educational institutions III-IV of the levels of accreditation in the field of 7.110101 “Medicine”, 7.110104 “Pediatrics” and 7.110105 “Medical-prophylactic case“ (Kiev, 2008). Under the new program, students of Vth year learn surgery on the subject of the module 2, “Thoracic, cardiovascular, endocrine surgery”, consisting of two informative modules 3 and 4. The textbook combines educational materials of department, dedicated for practical training (classroom studying 7 themes № 16-22) and for self extracurricular study of 5 subjects according to the thematic plans of discipline “surgery” on the subject of Module 2. Each topic is outlined in the textbook, contains sections that correspond to professionally-oriented tasks of medical practice, approved by industry standards of Higher Education – “Educational and professional program” and “Educational qualifying characteristic” (Kiev, 2003). Highlights issues of etiology and pathogenesis, classification of disease according to ICD-10 (2001), clinical symptoms, standard regimens of additional laboratory and instrumental examination of the characteristic features of evidence-based medicine for each disease, emergency care at the prehospital stage under emergency conditions in surgical patients, justifies the choice of treatment tactics , is pathogenetically grounded conservative therapy, indications and types of surgical interventions. Considerable attention is paid to modern minimally invasive interventions — video endoscope, VATS, X-ray endovascular. For each topic listed recommended modern literature. Prepared by the teaching staff of the Department of Surgery № 1 textbook is designed to provide students the necessary teaching materials integrated in all themes of workshops and self extracurricular work that will improve the training of future doctors surgery according to the requirements of national industry standard for higher education.Item Surgical tactics in fire kidney injury and the first experience in performing laparoscopic nephrectomy at the II level of medical support (role II) in combat conditions: Case report(2023-04-23) Gumeniuk, Kostyantyn; Lurin, Igor; Savytskyi, Oleksandr; Nehoduiko, Volodymyr; Makarov, Vitaly; Smolianyk, KostiantynIntroduction and importance: According to the data from the American Urological Association (AUA) and the European Urological Association (EAU) (2020), kidney is the most frequently damaged organ of the genitourinary system. Kidney damage occurs in approximately 5 % of injured people and accounts for 24 % of traumatic injuries to abdominal organs. Surgical treatment remains the gold standard in unstable patients with gunshot and stab wounds. Minimally invasive surgical treatment of kidney injuries, which is usually performed after laparoscopic diagnosis, at the II level of medical care becomes possible in the first hours after injury. Case presentation: We performed two laparoscopic nephrectomies caused by gunshot shrapnel damage to the kidney in a military mobile hospital at the II level of medical support. The time since the injury was 64 ± 16 min. The wounded were extubated after the operations, activated on the first day. In one case, the drain was removed on the third day, in the other – on the fourth day. During the monitored period (30 days) after the operation, there were no complications in both wounded. Clinical discussion: Laparoscopic nephrectomy in gunshot damage to the kidney was characterized by presence of a retroperitoneal tense hematoma. When opened, there were signs of bleeding from the kidney parenchyma, difficulty of anatomical visualization of anatomical structures - ureter, renal artery and vein. Conclusion: It is possible to perform endovideosurgical operations - laparoscopic nephrectomy in combat kidney injury at a military mobile hospital with available high-tech equipment at the II level of medical support (Role II), thus bringing highly specialized care closer to the wounded. We noted a better cosmetic effect after the laparoscopic operations