Primary Repair of Colon Wounds

Abstract

102 patients with penetrating intraperitoneal colon injuries were entered into a prospective study. Colon wound management was undertaken without regard to associated injuries or amount of fecal contamination. Primary repair was performed in 83 patients, segmental resection with anastomosis in 12, and resection with end colostomy in 7. There were no suture line failures in the primary repair group, and one suture line failure in the anastomosis group. The one failure was in a patient who underwent repeated explorations for bleeding before the leak occurred. The septic complication rate was 33% of the entire series and was unrelated to primary repair. Logistic regression analysis to identify risk factors for sepsis included transfusion greater than or equal to 4 units (p less than 0.02), more than two associated injuries (p less than 0.04), significant contamination (p less than 0.05), and increasing colon injury severity scores (p less than 0.02). The method of colon wound management, location and mode of injury, presence of hypotension (BP less than 90), and age did not significantly contribute to sepsis. We conclude that nearly all penetrating colon wounds can be repaired primarily or with resection and anastomosis, regardless of risk factors.

6 Year Prospective Clinical Trial of Primary Repair Versus Diversion Colostomy in Colonic Injury Cases

“…Complication rate in both groups will be same. This view is very close to a study done by few other authors [5,6]. They concluded that nearly all penetrating colon wounds can be repaired primarily or with resection and anastomosis, regardless of risk factor.…”

“…They concluded that nearly all penetrating colon wounds can be repaired primarily or with resection and anastomosis, regardless of risk factor. There were complications in some cases but none of these complications were because of anastomotic leak and fistula formation [5][6][7]. The main danger of colonic injury is sepsis resulting from fecal spill and we should be careful for this complication while deciding the management of colonic injury.…”

Rectum Perforation Due To Blunt Abdominal Trauma

“…12 Travmatik kolon ve rektum perforasyonlarında da genel eğilim bariz kontaminasyon veya ekstraperitoneal rektal yaralanma yoksa primer onarım yapılması yönündedir. 13 Olgumuzun erken prezentasyonu, genel durumunun iyi olması ve intraabdominal septik bulgular taşımaması göz önüne alınarak intraoperatif lavaj sonrası anastomoz yapılmış ve saptırıcı kolostomiye gerek görülmemiştir. Tanı ve tedavide gecikme nedeniyle önemli bir morbidite ve mortaliteye neden olabilecek rektal yaralanmaların gözden kaçmaması için çoklu travmalı bir hastada, ilk muayenede rektal muayenenin önemini tekrar hatırlatmak amacıyla bu vaka sunulmuştur.…”

Primary Repair or Colostomy in Colonic Injuries – Comparative Analysis With Literature Review

“…Sutura primară a fost utilizată în 41,6% din cazuri în timp ce rezecţia cu anastomoză în 17,1% din cazuri [42][43][44].…”

“…Leziunile care au necesitat rezecţii s-au finalizat în prima jumătate a studiului cu colostomie (7 cazuri), ulterior beneficiind de anastomoză primară (12 [44].…”