Laparotomy for Trauma in a Regional Centre: The Effect of Delay on Outcome

Abstract

From 1983 to 1990.110 patients with abdominal trauma required laparotomy in the Albury-Wodonga region. Splenic and liver injuries occurred in 50% of cases, and bowel trauma in 20%. The mortality rate was 8.2% (nine deaths) and major postoperative complications occurred in 18 patients (16%). Delay in therapeutic intervention of greater than 4 h from hospital admission led to a statistically significant increase in the complication rate (P < 0.01) despite a lower injury severity score in this group. Delayed repair of bowel injuries in particular led to an 80% major complication rate in survivors. A high index of clinical suspicion and the regular use of diagnostic peritoneal lavage is suggested to avoid such delays in diagnosis and subsequent surgery.

Splenic injury admitted to a rural Level 3 trauma centre: A 10‐year audit

“…Outside of the work of Stewart et al, 1 we are not aware of other published literature for splenic injury occurring in rural Australia. Minimal literature exists on a global scale.…”

“…1 The spleen is the most common abdominal organ injured in blunt trauma. 1 The spleen is the most common abdominal organ injured in blunt trauma.…”

“…1 The spleen is the most common abdominal organ injured in blunt trauma. 1 Isolated injuries are more common in paediatric populations and at non-trauma hospitals. 1 Isolated injuries are more common in paediatric populations and at non-trauma hospitals.…”

Gastrointestinal perforations: a tertiary care center experience

“…20 In this study there was a complication rate of 12.5%, which is comparable well with study by Stewart et al, wherein the complication rate noted was 16%. 21 The reviewed studies show that complications depend on type of injury, organ injured and duration prior to surgery. The overall mortality accounts in our study was 9.2% which is comparable to studies by and Jhobta et al where it was 10%.…”

The right team at the right time – Multidisciplinary approach to multi-trauma patient with orthopedic injuries

“…The importance of the team approach is exemplified by the fact that any delay in recognition of significant clinical events, and thus prolonged time to therapeutic intervention, may worsen outcomes. [1314] The overall outcome of severely injured patients depend on successful integration of medical, psychosocial, financial, educational, and vocational resources available across an array of specialties and various medical centers, programs, and organizations. [15] In sections that follow, we will discuss the care of the trauma patient from a number of different specialty perspectives.…”