Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care

Peer-review quarterly medical journal.

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Journal founders

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About

Scientific-practical Journal "Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care" is the official organ of the Russian Association of pediatric surgeons, published since 2010. 

In the Journal "Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care" articles of scientific and practical value for a wide range of surgeons and specialists of related professions are published. The journal presents the original work of scientists from CIS countries and far abroad, materials from the international and domestic conferences. Special attention is paid to main national projects in healthcare, high-tech types of medical care in various fields of pediatric surgery, organization of surgical care to children, the development of clinical guidelines, training of specialists. The editorial Board and editorial Council of Journal "The Russian Bulletin of pediatric surgery, anesthesiology and critical care medicine" is formed of prominent scientists, heads of leading hospitals, leading specialists and well-known children's surgeons and anesthesiologists-resuscitators from all over the world.

Types of accepted articles

  • reviews
  • systematic reviews and metaanalyses
  • original research
  • clinical case reports and series
  • letters to the editor
  • short communications

Publications

  • in English and Russian
  • quarterly, 4 issues per year
  • continuously in Online First
  • with NO Article Processing Charges (APC)
  • distribution in Open Access with the CC BY-NC-ND 4.0 License.

Indexation


 

Announcements More Announcements...

 

'Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care' journal accepted for indexing in SCOPUS

Posted: 20.07.2023

 

The 'Russian Journal of Pediatric SurgeryAnesthesia and Intensive Care' journal has been successfully evaluated and accepted for indexing in the SCOPUS database.

The Scopus Content Selection & Advisory Board (CSAB) has reviewed the journal and approved it for coverage. The message from CSAB was received on 06.04.2023.

Journal evaluation tracking URL: https://suggestor.step.scopus.com/progressTracker/?trackingID=3FB38F26BEA8BF3E 

All articles published in the journal from 2023 are subject for indexation.


 

Current Issue

Vol 13, No 4 (2023)

Original Study Articles

Business game “High-tech Pediatric Surgery”: Modeling of management decisions in children’s health protection in the Far Eastern Federal District
Morozov D.A., Rozinov V.M., Suvorov S.G., Ampar F.B., Strizhnev S.V., Vaganov N.N.
Abstract

BACKGROUND: The difference in the levels of total infant mortality in certain administrative territorial entities of the country is an acute medical and social problem of domestic healthcare, which indicates the absence of a single standard of accessibility and quality of medical care. This indicator in the Far Eastern Federal District significantly exceeds the corresponding indicators in the Central and Northwestern districts.

AIM: This study aimed to identify unresolved problems and identify ways to improve the availability and quality of surgical care for children by modeling the process of making administrative and clinical decisions by employees of medical organizations and heads of healthcare in the Far Eastern Federal District in the interests of children in need of specialized, including high-tech, medical care, including medical evacuation.

MATERIALS AND METHODS: A “business game” with simultaneous implementation of the simulation process in 11 regions of the Far Eastern Federal District was conducted using distributed communication channels and technical capabilities of audiovisual fixation of the opinions of the study participants. A series of five business games on the following profiles were implemented: neonatal surgery, thoracic surgery, neurosurgery, oncology, and combustiology. The scenarios of the games were prepared by the organizers of the study: “Russian Association of Pediatric Surgeons” (LLC) and “Agency for Strategic Initiatives to promote new projects” (ANO). The moderators of the games were leading specialists from specialized federal medical organizations. The game participants were regional teams of the subjects of the Far Eastern Federal District. The observers of the games were representatives of federal legislative and executive authorities and healthcare experts.

RESULTS: In this study, 9–11 regions of the Far Eastern Federal District participated in a series of five games. The total number of participants in business games ranged from 126 to 151, and the number of connection points was 42–66. The identified problematic issues included organizational (9), personnel (8), transport (7), equipment (7), and financial (6) aspects.

CONCLUSIONS: The ideology of the interregional centers of specialized surgical care for children corresponds to the vision of representatives of the professional community and organizers of territorial healthcare as a promising way to increase the availability and quality of medical care to the pediatric population.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):459-474
pages 459-474 views
One-stage reconstruction of four fingers in children using microsurgical autotransplantation of foot tissue complexes
Golyana S.I.
Abstract

BACKGROUND: Toe-to-hand transfer is still the most promising and relevant method for restoring fingers that are missing from birth or after injury. In cases requiring the restoration of two or more digits, simultaneous transplantation of tissue complexes from both feet, including one or two toes, is possible and necessary. Thus, a maximum of four fingers can be restored during one operation. Such operations, according to the literature, are performed extremely rarely because they are very extensive and time-consuming.

AIM: To present the results of simultaneous microsurgical autotransplantation of four toes to the hand in children with congenital and acquired pathologies.

MATERIALS AND METHODS: The study used clinical, radiological, and biomechanical methods to assess the results of nine patients with congenital and acquired upper limb deformities who underwent simultaneous microsurgical autotransplantation of two tissue complexes from each foot, including toes II–III. The indications for performing this method of microsurgical reconstruction in children with the absence of four (or all five) fingers have been determined. The results, postoperative complications, and conditions of the donor and recipient zones were analyzed.

RESULTS: To date, 914 such operations have been performed in children. In nine cases, four toes were simultaneously transplanted (two from each foot). The average age of the patients was 4.2 years. Two children had congenital malformations of the hand, and seven had consequences of trauma. In eight cases, fingers II–V were restored, and in one case, fingers I–IV were restored. Complications associated with impaired blood circulation in the grafts were observed in 22% of the cases; however, they were temporary. All transplanted grafts survived. All patients required continued surgical treatment after the toe transfer to improve their appearance and function. Biomechanical examination methods showed complete restoration of function on average of 4 months (±1 month) after surgery.

CONCLUSIONS: This study showed the possibility and effectiveness of using toes for hand transfer in children with both congenital and acquired hand pathologies that require the restoration of four fingers. Simultaneous microsurgical transplantation of toes ensures the restoration of a good appearance of the hand and its functionality.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):475-490
pages 475-490 views
Effectiveness of saline solutions in surgical interventions in newborns
Nasser M.M., Zhirkova Y.V., Kucherov Y.I.
Abstract

BACKGROUND: In recent years, neonatal surgery has been developing and improving, among other things, because of a deeper study of anesthesiological approaches and the introduction of acquired knowledge into the daily practice of an anesthesiologist-resuscitator. One of the basic factors that influence treatment outcomes in the future is a thorough study of infusion therapy methods in newborns, considering the anatomical and physiological characteristics of the neonatal period.

AIM: This study aimed to examine the electrolyte balance, acid–base state, and hemodynamic parameters in newborns, depending on the choice of basic infusion medium during surgery.

MATERIALS AND METHODS: A prospective study was conducted in 99 newborns. All children were given an infusion of saline solutions of 10 mL/kg/h during surgery. Groups I, II, and III were administered intraoperatively with isotonic Sterofundin, saline solution, and Ringer’s solution, respectively. A hypotonic sodium chloride solution of 0.45% was administered to 11 children. The indicators of the acid–base state and electrolyte composition of the venous blood, hemodynamic parameters, and need for perioperative inotropic support were evaluated.

RESULTS: A tendency to hyponatremia was detected in children who were infused with 0.45% sodium chloride hypotonic solution, which resulted in the abandonment of further recruitment of children in the group and the implementation of this study option. After surgery, the pH-compensated state was maintained in all three groups. Moreover, metabolic disorders in the form of a decrease in bicarbonates and ВE were recorded in all groups. Electrolyte disturbances were detected in all groups, whereas electrolyte balance was most often registered in group I. In groups II and III, common ionogram findings included a decrease in potassium and an increase in sodium, chlorine, and calcium levels. In the analysis of the hemodynamic parameters, no significant statistical difference was recorded during surgery when comparing the groups infused with different saline media.

CONCLUSIONS: In this study, no significant differences were found in the indicators of acid–base state and hemodynamic parameters when using different saline solutions as basic intraoperative infusion therapy in newborns. Regarding the electrolyte balance, the most common complications were hypokalemia, hypernatremia, and hyperchloremia in the 0% saline group.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):491-502
pages 491-502 views
Comparative analysis of the results of multispiral computed tomography using color mapping and magnetic resonance imaging in the diagnosis of acute hematogenous osteomyelitis in children
Pozdnyakov A.V., Svarich V.G., Lyurov D.A.
Abstract

BACKGROUND: Although acute hematogenous osteomyelitis is considered a fairly well-studied disease, several articles emphasize that the frequency of diagnostic errors remains quite high. The clinical presentation of acute hematogenous osteomyelitis largely depends on its reactivity and localization. The latter has features of the clinical course in children of different age groups. Osteomyelitis can be difficult to detect because of the variability and nonspecificity of symptoms and physical and laboratory parameters. Rapid diagnosis is crucial for successful disease outcomes because untimely treatment increases the number of complications. Therefore, visualization should be aimed at early diagnosis and, ultimately, successful treatment.

AIM: This study aimed to evaluate the informative value of magnetic resonance imaging and multispiral computed tomography (MSCT) in the diagnosis of the intramedullary phase of acute hematogenous osteomyelitis as its earliest stage.

MATERIALS AND METHODS: Thirty patients suspected with acute hematogenous osteomyelitis underwent magnetic resonance imaging and MSCT using color mapping techniques and X-ray density assessment. At the final stage of the diagnostic algorithm, osteotonometry was performed. The contents of the bone marrow canal were taken for microbiological and bacteriological studies.

RESULTS: In the intramedullary phase of acute hematogenous osteomyelitis, magnetic resonance imaging and MSCT revealed signs of bone marrow edema in 96% of the cases. The sensitivity of magnetic resonance imaging was 96%, the same as that of MSCT; however, the specificity was significantly lower than that of MSCT using the color mapping method and X-ray density assessment, which was 67% and 83%, respectively (p < 0.05).

DISCUSSION: In recent years, the role of computed tomography in the diagnosis of acute hematogenous osteomyelitis has received considerable recognition in pediatric surgical practice, and MSCT with color mapping and X-ray density assessment in the diagnosis of acute hematogenous osteomyelitis in children has been used relatively recently. Simultaneously, many researchers have reported the high informativeness of MSCT in the diagnosis of acute hematogenous osteomyelitis.

CONCLUSIONS: The intramedullary phase of acute hematogenous osteomyelitis according to magnetic resonance imaging and MSCT indicates bone marrow edema as its earliest stage. According to the data of the present study, MSCT using color mapping and X-ray density assessment has high specificity and can be used with MRI as the main method for diagnosing the intramedullary phase of acute hematogenous osteomyelitis.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):503-511
pages 503-511 views

Reviews

Experimental modeling of necrotic enterocolitis: A review
Severinov D.A., Lipatov V.A., Gavrilyuk V.P., Ivanova E.A.
Abstract

Neonatal necrotizing enterocolitis (NEC) is a multifactorial disease of unspecified etiology. The lack of data on etiological factors and the complexity of pathogenetic mechanisms determine the complexity of NEC modeling. The authors involved in the study of the pathogenesis of NEC and the development of current treatments seek to model in the experiment the conditions that occur in clinical practice. Thus, this study aimed to analyze the options for the experimental modeling of neonatal NECs described in the public domain. Thus, more than 50 relevant scientific publications in databases such as Google Scholar, PubMed, Scopus (publishers Elsevier), and eLibrary (from 2000 to 2022) were reviewed. This paper describes the most current methods of modeling NEC, including in vitro (using cells and cell cultures), in vivo (in laboratory animals such as mice, rats, rabbits, and pigs), and ex vivo (using cadaver material) experiments.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):513-524
pages 513-524 views
Unplanned extubation in intensive care pediatric patients — status of the problem: A literature review
Yakushev D.V., Azovskiy D.K., Protsenko D.N., Afukov I.I.
Abstract

Unplanned extubation is any removal of an endotracheal tube from the airway during mechanical ventilation that is not planned, premeditated, or controlled. The frequency of unplanned extubation is one of the most important indicators of the quality of care in the pediatric intensive care unit, and according to the literature, it ranges from 0.11 to 6.4 per 100 days of mechanical ventilation. Unplanned extubation leads to severe complications, worsens outcomes, and increases treatment costs, which determine the urgency of the problem. The search for relevant publications was conducted in PubMed, Google Scholar, and eLibrary.ru. The review included 37 articles published from June 1997 to July 2023. The articles contained information on the incidence of unplanned extubations in pediatric and neonatal intensive care units, their complications, and associated factors. It also presented measures aimed at improving the quality and safety of medical care and reducing the frequency of unplanned extubations, with an analysis of their effectiveness. No studies have focused on the frequency of unplanned extubations in Russia, which is a good motivator for conducting research on unplanned extubations in the national healthcare system. The authors hope to draw the attention of clinicians and healthcare managers to this problem as one of the criteria for the quality and safety of medical care for children.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):525-535
pages 525-535 views
Regional anesthesia for hip surgery in children: A review
Novikova V.S., Kuleshov O.V., Ulrikh G.E.
Abstract

Hip joint diseases are one of the most common and difficult problems in pediatric orthopedics, often requiring surgical treatment. In children, intra- and postoperative analgesia after hip surgery is more conservative and limited to epidural anesthesia, which has known disadvantages and limitations, despite the high quality of pain relief. Peripheral regional blocks in hip surgery are widespread in adults. Ultrasound navigation makes peripheral blockades safer and more effective. This largely influenced the spread of their use in children and contributed to the introduction of new methods of planar blockades into practice. The authors analyzed studies on the efficacy and safety of modern methods of peripheral regional blockade used in children during hip surgery. The literature search was conducted in the eLibrary, PubMed, and Scopus databases. By using keywords, 750 literature sources were found, and 65 sources relevant to the purpose of the study were included in the review. The lumbar plexus block and fascia iliaca block are the most studied regional techniques in children, which are not inferior in analgesic efficacy to lumbar epidural and caudal anesthesia. A new and promising method of regional anesthesia of the hip is the pericapsular nerve group block, which has been well studied in adults. However, none of the peripheral regional techniques used for analgesia after hip surgery, has not proven its advantages. Further clinical studies are needed to investigate peripheral regional anesthesia techniques and determine their efficacy and safety in pediatric hip surgery.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):537-550
pages 537-550 views
Urine metabolome investigation in pediatric urology. Review
Kuzovleva G.I., Vlasenko E.Y., Maltseva L.D., Morozova O.L.
Abstract

Metabolomics is the science of studying small molecules (50–5,000 Da) formed because of the implementation of metabolic pathways in cells and the maintenance of their vital functions. The study of urine metabolome is a promising direction for diagnosing early stages of damage to various cells of the urinary system in pediatric urology, allowing the study of biomarkers or their spectrum, which can improve the identification of existing disorders, and multivariate analysis will provide greater accuracy in making a diagnosis. This study aimed to summarize existing information on urine metabolome and its changes in cases of congenital malformations of the urinary system, accompanied by renal dysplasia, leading to acute kidney injury or chronic kidney disease. A literature search and review was conducted using PubMed, Embase, and Google Scholar. The review presents the possibilities of metabolomic analysis to provide a qualitatively new level of diagnosis and monitoring of damage to the structures of organs and tissues of the urinary system, identifying predictors of pathology progression, and personalized techniques for making medical decisions. However, this method is limited by the high cost of the equipment, need for training of highly qualified personnel, and difficulty in interpreting the results. The study of urine metabolome is very promising for the diagnosis and selection of a timely, rational treatment strategy for children with malformations of the urinary system.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):551-563
pages 551-563 views

Case reports

Robot-assisted transposition of aberrant lower polar renal vessels in a 14-year-old child with vasorenal hydrophnerosis
Kozlov Y.A., Poloyan S.S., Sapukhin E.V., Strashinsky A.S., Makarochkina M.V., Marchuk A.A., Rozhanskii A.P., Byrgazov A.A., Romanovich E.S., Narkevich A.N.
Abstract

This study presents a patient with pyeloureteral segment obstruction caused by aberrant inferior polar vessels using the robotic Hellström – Chapman procedure and reports its short-term results. A 14-year-old girl was admitted to Irkutsk Regional Children’s Clinical Hospital because of obstruction of the pyeloureteral junction caused by external compression by aberrant lower polar vessels. The diagnosis was established by ultrasonography and Doppler sonography and confirmed by contrasted computed tomography. Surgery was performed using the Versius surgical robot manufactured by CMR (UK). Delicate actions were used to mobilize the abnormal vessels and move them to the anterior wall of the pelvis. Then, they were “wrapped” with the anterior wall of the pelvis. Postoperative follow-up included clinical evaluation and renal ultrasound examination 1, 3, and 6 months after surgery. The operative duration was 65 min. During the robot-assisted Hellström – Chapman operation, no intraoperative complications, such as damage to the vessels supplying the kidney and neighboring organs, were noted. The patient did not require internal or external drainage of the upper urinary tract or perinephric space. The anteroposterior diameter of the pelvis decreased from 30 to 8 mm. The resistive index of the blood flow in the renal vessels decreased from 0.74 to 0.58. The Hellström – Chapman robotic procedure is a safe and effective procedure for the correction of vasorenal hydronephrosis. However, this surgery requires patient selection to ensure future treatment success.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):565-575
pages 565-575 views
Commentary on “Robot-assisted transposition of aberrant lower polar renal vessels in a 14-year-old child with vasorenal hydrophnerosis”
Rudin Y.E.
Abstract

This is a commentary on the article by Kozlov Yu. A., Poloyan S.S., Sapukhin E.V., Strashinsky A.S., Makarochkina M.V., Marchuk A.A., Rozhansky A.P., Byrgazov A.A., titled, “Robot-assisted transposition of aberrant lower polar renal vessels in a 14-year-old child with vasorenal hydrophnerosis.” It was published in the Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):565–575. (In Russ.) DOI: 10.17816/psaic1544

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):577-581
pages 577-581 views
Post-injection necrotic phlegmon of the penis in a 13-year-old boy
Mohammad B., Tsibin A.A., Degtyarev P.Y., Kruck N.N., Sidorov A.D., Trubnikov E.A., Yakunov A.N., Porfirieva I.L.
Abstract

The practice of injecting various substances into the tissues of the penis in order to increase its size is found among adult men in different countries. An analysis of domestic and world literature revealed only one publication of a clinical case of treatment of a 16-year-old teenager with penile oleogranuloma. A 13-year-old boy was admitted to the pediatric surgical department with complaints of pain and severe swelling of the penis. According to the patient (found out later), these symptoms appeared 3 days after injecting 4 ml of Vaseline oil with a syringe under the skin of the penis. Swelling and hyperemia of the skin appeared, the next day the temperature rose to 40 °C, dizziness, nausea appeared, there were repeated vomiting and loose stools. The cause of the disease was established only after detailed questioning in the department. Local status: the penis is sharply increased in volume due to pronounced vitreous edema, mainly along the dorsal surface, the skin is hyperemic with dark areas and detachment of the epidermis. Diagnosis: “Necrotizing phlegmon of the penis, condition after injections of Vaseline oil”. After medical preparation, surgery was performed. Under endotracheal anesthesia, a 2 cm incision was made along the dorsal surface of the penis. A turbid liquid of 35–40 ml was released from the wound cavity, drainage was done with rubber drains. After the operation, antibacterial therapy and dressings with hydrophobic ointment were carried out. The general condition of the child returned to normal, the wound was cleaned, a defect measuring 5 × 3 × 0.2 cm was formed. After 2 weeks, plastic surgery was performed according to the Diettel method: the foreskin was cut to the area distal to the granulating wound, the outer and inner leaves of the foreskin were sharply separated, a graft was formed from the outer layer and fixed to the wound. The postoperative period was favorable, healing was by primary intention. The patient was discharged in satisfactory condition on the twenty-fourth day from hospitalization. When examined after 4 months, the patient has no complaints; on the dorsum of the penis there is a normotrophic scar measuring 2 × 3.5 cm, which does not interfere with skin mobility. The introduction of foreign bodies under the skin of the penis, accompanied by serious complications, began to be practiced among adolescents. Therefore, this case report will be of interest not only for pediatric surgeons and urologists, but also for doctors of other specialties who may be approached by patients with changes in the penile area, since a true history cannot always be ascertained.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):583-590
pages 583-590 views
Prolonged venous hemodiafiltration and hemoperfusion with polymixin in fulminant meningococcal disease: A case report
Serednyakov K.V., Aleksandrovich Y.S., Pshenisnov K.V., Konev A.I., Ioffe M.Y.
Abstract

Fulminate meningococcal infection is one of the most formidable life-threatening conditions in children, accompanied by a high probability of complications and adverse outcomes, including disability, irreversible damage to the central nervous system, and death. The key link in the pathogenesis of this condition is the massive release of endotoxins by the pathogen and total damage to the endothelium of all vessels, which underlies the development of septic shock and all complications. The use of extracorporeal hemocorrection methods is one of the most effective methods of treating fulminate meningococcal infection; however, despite the undoubted therapeutic effect, they are not included in the recommendations of a high level of evidence and are rarely used in routine clinical practice and, in most cases, only in the terminal phase of the disease. The study presented the characteristics of the course of generalized meningococcal infection in a 7-year-old child, including intensive care measures. Particular attention was paid to assessing the severity of the condition and the effectiveness of extracorporeal hemocorrection methods. The child’s condition upon admission to the intensive care unit was 11 points according to the pSOFA scale, which indicated the presence of decompensated multiorgan dysfunction and was the basis for prolonged venovenous hemodiafiltration. Based on the results of the endotoxin activity assay (0.67 units), hemoperfusion with polymyxin was conducted. During therapy, the patient’s condition stabilized. Sixty-eight hours after admission, medical support for hemodynamics was discontinued, and the parameters of invasive mechanical ventilation were reduced. On day 7 of treatment, the patient was extubated, and the events of respiratory distress did not increase over time. On day 8 after admission, with full compensation of all vital functions following ischemic damage and deep necrosis of the tissues of the lower extremities, the patient was transferred to a multidisciplinary surgical hospital for further treatment. Early informed use of extracorporeal hemocorrection techniques contributes to the rapid regression of septic shock events and recovery of the patient, demonstrating the high efficacy of the methods used and the need for further multicenter randomized trials to routinely use these therapies in clinical practice.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):591-598
pages 591-598 views
Craniofacial wound from a traumatic pistol injury in a 3-year-old child
Petlakh V.I., Gorchakov S.A., Divilina Y.V.
Abstract

With the advent of traumatic self-defense weapons among Russian civilians (weapons of limited destruction and nonlethal kinetic weapons), several studies on injuries among the adult population have been published in the medical literature. Skull injuries are the most severe, often fatal, injuries. To date, there are only isolated descriptions of such injuries in children.

Description of the observation. According to the parents, the 3-year-old boy shot himself in the face with an Osa-4 pistol at home. He did not lose consciousness, and the bleeding was light. He was admitted to the central district hospital, from where he was evacuated by an ambulance team to Children’s City Clinical Hospital No. 9 named after. G.N. Speransky, Moscow. Upon admission, the patient was in a serious condition, conscious, and lethargic, reacted negatively to examination, and had 14 points on the Glasgow coma scale, and his hemodynamics was stable. Local status: In the upper part of the dorsum of the nose, a bullet entry hole was observed in the form of a bruised wound of irregular shape, pronounced swelling in the area of the left orbit, and hematoma of the upper eyelid. X-ray images of the skull showed a shadow of a foreign body (bullet) in the projection of the left orbit and ethmoidal labyrinth. The location and extent of damage were clarified by computed tomography. Under endotracheal anesthesia, a supraorbital trans-eyebrow approach on the left with layer-by-layer tissue dissection along the wound canal exposed a part of the bullet, wedged into the medial wall of the orbit and cells of the ethmoid bone. The bullet was removed, and bone fragments and layer-by-layer sutures were removed. Diagnosis: Gunshot causing a blind craniofacial non-penetrating wound in the dorsum of the nose and left orbit, multiple comminuted fractures of the ethmoid bones and superior and medial walls of the left orbit, contusion of the basal parts of the left frontal region of the brain, blunt trauma OS stage 2, local contusion, and retinal hemorrhage The postoperative period passed without complications. The child received a combination of antibacterial and restorative therapy. Vision was preserved, no neurological disorders were detected, and the cosmetic result was good. The patient was discharged in satisfactory condition under the supervision of an ophthalmologist, neurologist, and maxillofacial surgeon. This observation is presented to demonstrate damage to skull structures from traumatic weapons and will aid in further generalization of the treatment results of this type of wound in children. Prevention of injuries in children from traumatic weapons requires extensive educational work among parents who own these weapons.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):599-608
pages 599-608 views

PERSONAL

To the Anniversary of Igor V. Shvedovchenko
Rybchenok V.V.
Abstract

This paper describes the professional activities and merits of the pediatric and orthopedic surgeon Igor V. Shvedovchenko in celebration of his birthday.

Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2023;13(4):609-611
pages 609-611 views


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