Кафедра хірургії № 4
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Browsing Кафедра хірургії № 4 by Subject "2023a"
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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 Mathematical Modelling of the Multifactorial Influence of Striking Fragments on the Dynamics of the Rehabilitation Processes of the Wounded.(2023) Kolisnyk, Kostiantyn; Sokol, Yevgen; Shchapov, Pavlo; Nehoduiko, VolodymyrThe article analyses the possibility of solving an important scientific and technical problem that is relevant for the security and defence of any country where natural and man-made disasters, military conflicts and other emergencies occur, in which penetrating injuries of people occur. The article reports on the possibility of improving the efficiency of the rehabilitation technology for patients with penetrating gunshot wounds by reducing the rehabilitation period using modern methods of medical diagnostics, mathematical modelling and statistical methods for processing biomedical information. The scientific idea underlying the conducted research is that dynamic changes of a set of biomedical indicators depend not only on the time of their observation, but also on the levels of those physical factors that characterize physical parameters: temperature and dynamics of fragments. As a working hypothesis, in this case, it is possible to consider the inverse task, in which it is possible to solve the problem of assessing the levels of physical factors characterizing fragments using measurements of biomedical indicators during the initial examination of the wounded. In the paper, the authors substantiated the possibility of using primary biomedical measurements to assess the physical characteristics of fragments. This, in turn, makes it possible to take into account the characteristics of the physical impact of fragments on the dynamics of changes over time in biomedical indicators characterizing the treatment, and will lead to a reduction in rehabilitation timeItem Method for measuring X-ray reflections of microelements of inorganic compounds in soft tissues(2023-07-25) Mikhailov, I.; Negoduyko, Volodymyr; Mikhaylusov, R.; Mikhailov, A.; Borisova, S.An alternative method is proposed for measuring X-ray diffraction peaks from micro-impurities of inorganic phases in soft tissues. Unlike traditional XRD, each of the diffraction peaks corresponding to the interplanar spacing di , is measured using radiation with a wavelength of λi →2di . This makes it possible to register diffraction peaks at large θ angles, thereby increasing the angular resolution ∼tanθ. This approach made it possible to increase the beam angular divergence ∆θ from 0.05° (for standard XRD) to 3°, gain ∼(∆θ) 2 in the spectrometer luminosity, and reduce ∼(∆θ) -2 radiation load per unit area of soft tissue. A criterion for choosing the wavelength and beam divergence based on the micro-impurity structure is proposed. The results of measuring the diffraction peaks of micro-impurities of iron oxides in soft tissues damaged by a fragment wound are presented. The excess iron content in damaged tissues was certified by the XRF method with calibration using standard samples and did not exceed 0.4 mass%. Measurements of the main diffraction peaks of iron oxides Fe2 O3 , d=2.69Å, as well as Fe3 O4 , d=1.61Å and FeO(OH), d=1.71Å, were carried out in Cl- Кα ( . λ = 4 728 ) and Sc-Кα ( λ = 3. ) 031 , respectively. We used the scheme of a portable EDXRF spectrometer with a secondary KCl-Sc target and an angular beam divergence of ∆θ≈3°. Without radiation damage to soft tissues, the detection limits were reached: 0.12 mass% for Fe2 O3 , 0.059 mass% for Fe3 O4 and 0.034 mass% for FeO(OH)Item Microbiological analysis of abdominal cavity exudate, blood and affected tissues samples from patients with intra-abdominal abscesses in complicated infection of abdominal cavity(2023) Mozgova, Yulia; Mishyna, Marina; Syplyviy, Vasyl; Ievtushenko, Olexandr; Ievtushenko, Dmytro; Marchenko, Iryna; Mishyn, YuriyThe aim: To conduct an analysis of the results of a microbiological examination of biological samples taken from patients with intra-abdominal abscesses. Materials and methods: Material for microbiological examination was collected from 60 patients during surgery and transported to laboratory at the same day. Isolation and identification of microbial pure cultures were performed by standard microbiological methods. Statistical analysis was performed using Statistica software. Results: Analyzing the microbiological research results indicated importance of the sample collecting time (first or repeated surgery). In patient’s blood taken during first surgery it was found a statistically significant predominance of no growth of microflora. In abdominal cavity exudates anaerobic cultures increased statistically significantly in repeated surgery. It was noted that in samples taken during first surgery mixed pathogens were represented mainly by facultative anaerobic cocci, then in repeated surgery anaerobic microorganisms were predominant. Examination of liver abscess content found that monoculture was isolated in 85.7 %. Blood and affected tissue samples in such patients were sterile. Investigation of samples from patients with multiple abdominal cavity abscesses revealed anaerobic microorganisms in 16.7 %. Blood samples of that patients in 40 % were sterile. Conclusions: An analysis showed that in appendicular abscesses content gram-negatives were predominant. Gram-positive bacteria dominated in paravesical abscesses with 65 % isolates from gallbladder and 66.7 % from the affected tissue samples. In liver abscesses gram-positive cocci were isolated in 57.1 %. In multiple abdominal abscesses due to bowel perforation rod-shaped microflora was predominant (76 %) and represented by either obligate aerobes or obligate and facultative anaerobes.