Wound Management After Trauma to the Colon

Cr, Voyles; Lm, Flint

doi:10.1097/00007611-197709000-00017

Cited by 15 publications

(5 citation statements)

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“…Our main focus in performing this study was to examine the wound infection rate and to determine adequate wound management for patients with isolated small bowel and stomach injuries. For colonic injuries, the wound infection rate ranges from 2.7% to 65.0% [8, 20, 21]. Many trauma surgeons manage such wounds with delayed primary closure.…”

Section: Discussionmentioning

confidence: 99%

Analysis of 178 Penetrating Stomach and Small Bowel Injuries

et al. 2008

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Surgical site infections (SSIs), such as wound infection, fascial dehiscence, and intraabdominal abscess, commonly occur following penetrating abdominal trauma. However, most of the literature involves penetrating colon injuries. There are few reports describing complications following penetrating stomach and small bowel injuries. Based on the hypothesis that SSIs are commonly found following penetrating stomach and small bowel trauma, a prospective observational study was performed at an academic Level I trauma center from March 1, 2004 until August 31, 2006. The subjects were patients who had sustained a penetrating injury to the stomach or small bowel. Patients were followed for the development of an SSI, defined as wound infection, fascial dehiscence, or intraabdominal abscess. A total of 178 patients were admitted with penetrating stomach or small bowel injuries over the 29-month period. There were 121 (68%) gunshot injuries and 57 (32%) stab wounds. Associated intraabdominal injuries occurred in 74% of patients. Overall, SSIs occurred in 20% of cases. Risk factors for SSI included associated duodenal or colon injury, whereas time to operating room, blood loss, and type and duration of antibiotic use were not. When associated colon injuries were excluded, SSIs occurred in 16% of patients with gastric injuries and 13% of those with small bowel injuries. SSIs commonly follow penetrating stomach and small bowel trauma. Risk factors for SSI include associated duodenal or colon injury. Delay to operating room, blood loss, and type and length of antibiotic prophylaxis were not associated with an increased risk of SSI.

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Section: Discussionmentioning

confidence: 99%

Analysis of 178 Penetrating Stomach and Small Bowel Injuries

et al. 2008

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“…Two studies in patients with traumatic colonic injuries both found a significantly higher incidence of SSI associated with primary wound closure. Voyles and Flint reported an SSI rate of 56 per cent in primarily closed skin wounds, significantly higher than the rate of 19 per cent in patients treated with delayed closure by primary or secondary intention. In a randomized clinical trial of 48 patients, Velmahos and colleagues reported a twofold increase in SSI with closed wounds (65 versus 36 per cent; P = 0·004) but no statistically significant increase in wound dehiscence ( P = 0·18).…”

Section: Discussionmentioning

confidence: 91%

Primary skin closure after damage control laparotomy

Pommerening¹,

Kao²,

Sowards³

et al. 2015

Journal of British Surgery

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“…There are a few studies that specifically address outcomes following closure, with a study from 1977 citing infectious rates following primary closure at 56%, delayed primary closure at 19%, and intraperitoneal abscess rates of 73%. 106 However, modern management of wounds following trauma has dramatically changed, especially with the introduction of negative pressure dressings and dramatic technologic improvements in nursing wound care. 107 There are some data that indicate that abdominal wall closure for open abdomens beyond 5 days may impact subsequent leak rates, 108 and surgeons should be diligent in following the wound for early signs of problems.…”

Section: Operative Approachmentioning

confidence: 99%

Historical and Current Trends in Colon Trauma

Causey

Rivadeneira

Steele

2012

Clinics in Colon and Rectal Surgery

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The authors discuss the evolution of the evaluation and management of colonic trauma, as well as the debate regarding primary repair versus fecal diversion. Their evidence-based review covers diagnosis, management, surgical approaches, and perioperative care of patients with colon-related trauma. The management of traumatic colon injuries has evolved significantly over the past 50 years; here the authors describe a practical approach to the treatment and management of traumatic injuries to the colon based on the most current research. However, management of traumatic colon injuries remains a challenge and continues to be associated with significant morbidity. Familiarity with the different methods to the approach and management of colonic injuries will allow surgeons to minimize unnecessary complications and mortality.

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Wound Management After Trauma to the Colon

Cited by 15 publications

References 0 publications

Analysis of 178 Penetrating Stomach and Small Bowel Injuries

Analysis of 178 Penetrating Stomach and Small Bowel Injuries

Primary skin closure after damage control laparotomy

Historical and Current Trends in Colon Trauma

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