Summary. The aim of the study was to improve the quality of diagnosis of chest injuries and to optimize surgical tactics through the use of spiral computed tomography. Material and research methods. The work is based on prospective analysis of the results of spiral computed tomography of patients with chest injuries for the period from 2014 to 2020. Results and its discussion. The results of SCT make it possible to objectify the choice of surgical tactics and the most rational type of access. The use of SCT has become expedient for chest injuries both before surgery in patients with stable hemodynamics and in the postoperative period to identify early complications. Conclusions. Based on the study, it was concluded that the use of SCT in patients with chest wounds makes it possible to choose rational treatment tactics, optimal access for surgery and drainage area, as well as apply minimally invasive treatment methods. Conducting CT studies in dynamics allows us to assess the effectiveness of conservative and surgical treatment and promptly make adjustments to the treatment.

Summary. The arms — to analyze the evolution of the development of modern surgical instruments in gunshot wounds chest. Materials and methods. 80 cases of using a modern magnetic surgical instrument for penetrating gunshot wounds of the chest were analyzed. Intraoperatively used: a magnetic multifunctional tool for the diagnosis and removal of metallic ferromagnetic foreign bodies, a flexible device for removing ferromagnetic foreign bodies, a magnetic tool for endovideoscopic diagnosis and removal of metallic ferromagnetic foreign bodies from the abdominal and pleural cavities, a magnetic nozzle for video endoscopic surgical interventions. When removing metal foreign bodies, the following methods were used: a method for preliminary determination of the material and properties of a foreign body, a method for video endoscopic laser visualization of the internal organs of the abdominal and pleural cavities. Results. Foreign bodies of the pleural cavity were diagnosed in 80 (100 %) wounded according to СT. Ferromagnetic metal foreign bodies of a gunshot origin of the pleural cavity were removed both during thoracotomy or minithoracotomy, and during thoracoscopic surgical interventions using the method of video endoscopic laser visualization of the internal organs of the abdominal and pleural cavities. The most convenient tool was the endoscopic magnetic tool for removing foreign bodies from the pleural or abdominal cavities. A magnetic nozzle for video endoscopic surgical interventions allows navigation both in the pleural cavity and along the wound channel. Conclusions. 1. The development of a surgical magnetic instrument was phased and began with the improvement of a surgical magnetic instrument to remove ferromagnetic foreign bodies of soft tissues. 2. The improvement of the tool took place as the restrictions on the use of the existing tool were established, which was a prerequisite for the development of a new tool. 3. It is advisable to create a special set of surgical magnetic instruments for video endoscopic surgery.

Summary. The results of treatment of 108 patients with unstable fractures of the pelvic bones and internal organs lesions were provided for the period from 2009 to 2017, 56 of them were victims of the proposed tactic, which allowed to reduce the postoperative mortality by 17,3 %, the frequency of purulent-septic complications by 14,7 %.

Sumary. The aim is to investigate the features of pathogenesis in capsule formation around metallic foreign bodies of soft tissues. Materials and methods. The results of a study of 6 patients with metallic foreign bodies of soft tissues with a carrier period of 16 to 50 years were analyzed. 3 injured had foreign bodies of gunshot origin and 3 patients had foreign bodies as a result of personal injury. Used clinical, laboratory, instrumental, histological, immunohistochemical, X-ray spectrometric studies. Results. All foreign soft tissue bodies were removed with the capsule. By gender: 5 men and 1 woman. By localization - the lower extremity. Pain was present in all the victims. Radiography and ultrasound were informative, magnetodetection is informative only at the superficial location of a foreign body. The foreign bodies were made of gray cast iron and steel needle wire. Histologically, immunohistochemically and radiospectrometrically, it has been found that the capsule formation around the foreign body is affected by the mechanism and extent of damage to the soft tissues, the composition of the metal and its coating, and the carrier term of the foreign body. Conclusions. Depending on the composition of the metal and its coating, there is a different rate of oxidation of the foreign body in the soft tissues: oxidation of metal foreign bodies of fire origin is faster. The formation of the capsule around the foreign body is affected by the mechanism of tissue damage: when the needle penetrates, the soft tissues are destroyed minimally, in the case of gunshot wounds, they are destroyed more. Spectral analysis data in conjunction with morphological studies are the basis for the removal of a foreign body of inflammatory origin along with the capsule.

Summary. The article presents the data of local application of a 0.02 % decasan solution in patients with traditional «open» obviously clean planned surgical interventions on the gastrointestinal tract without perioperative antibiotic prophylaxis. Objective: to provide intraoperative protection of traditional “open” clean planned surgical interventions and to achieve the prevention of purulent-inflammatory complications through local clinical use of decasan without perioperative antibiotic prophylaxis. Materials and methods. The study involved 63 patients who were treated at the clinic of the State Institution «Institute of General and Emergency Surgery named after V. T. Zaitsev NAMS of Ukraine» and operated in a planned manner regarding umbilical and inguinal hernia. He performed the traditional «open» clean surgical interventions — hernioplasty. All patients participating in the study were divided into two groups. The main group consisted of 29 (46.1 %) people who, for the purpose of intraoperative protection of the performed interventions, were locally irrigated with the cavity of the surgical wound and suture line with a solution of universal antiseptic decasan, 1 ml of which contains 0.2 mg of decamethoxin, without perioperative antibiotic prophylaxis. The comparison group consisted of 34 (53.9 %) people who underwent antibiotic prophylaxis with parenteral administration of 1.0 g cefipime during the perioperative period. Results. When conducting a preliminary bacteriological study of smears performed intraoperatively in patients in the group with clinical use of decasan by soaking all the walls of the surgical wounds (initial data before treatment with the drug), the absence of pathological microflora growth was revealed. Conclusions. It is concluded that the local clinical use of decasan in patients with gastrointestinal tract pathology when performing “open” obviously clean planned surgical interventions fully ensures their adequate intraoperative protection without perioperative antibiotic prophylaxis.