Mistakes while application of modern surgical magnet instruments for diagnosis and removal of the ferromagnetic foreign bodies

E. Horoshun, I. Lurin, V. Nehoduiko, V. Makarov, S. Tertyshnyi, R. Saliutin
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Abstract

Objective. To analyze the mistakes while application of modern surgical magnet instruments for diagnosis and removal of ferromagnetic foreign bodies. Materials and methods. In accordance to the exploitation-clinical criteria, the material, delivered by usages of the magnet instruments (623 respondents), about results of its clinical usage in period from 2014 yr up to nowadays, was analyzed. Results. In total the mistakes while application of surgical magnet instruments may be divided on two groups: the clinical and exploitation-technical  Most quantity of clinical mistakes are connected with application of such instruments without indications, basically in absence of ferromagnetic fractures inside the wounds channels and cavities. Other causes of the mistakes were following: failure to include physiologic peculiarities of the wound process course, such as formation of capsule over foreign bodies, characteristic of the wound channel, choice of inappropriate nomenclature specimen and failure to include the vessels and neural trunks projections, leading to development of complications (hemorrhage, neuralgia, paresis), formation of  the contraperture incision and mechanical removal of the fracture. Sterilization in a dry-heat wardrobe and physical damage of instruments were taken into account and have been considered as an exploitation-technical mistake. Conclusion. In accordance to the results obtained, the conduction of educational trainings for usage of surgical magnet instruments, guaranteeing reduction of the various mistakes and complications quantity, leading to maximal effect of its application are recommended.
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现代外科磁铁器械在铁磁异物诊断与清除中的错误
目标。目的:分析现代外科磁铁器械在铁磁性异物诊断和清除中的错误。材料和方法。按照开发-临床标准,对623名受访患者2014年至今临床使用磁性仪器的结果进行分析。结果。总的来说,手术用磁性器械的错误可分为临床错误和应用技术错误两大类,大多数临床错误与无指征使用此类器械有关,基本上是在伤口通道和腔内没有铁磁性骨折。其他错误的原因还包括:未能包括创面过程的生理特点,如异物上形成囊,创面通道的特征,选择不适当的命名标本,以及未能包括血管和神经干的突出,导致并发症的发生(出血,神经痛,神经麻痹),挛缩切口的形成和骨折的机械移除。在干热衣柜中灭菌和仪器的物理损坏被考虑在内,并被认为是一个开发技术错误。结论。根据所获得的结果,建议开展手术磁铁器械使用的教育培训,保证减少各种错误和并发症的数量,使其应用效果最大化。
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