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Stab wounds to the back/flank in hemodynamically stable patients: evaluation using triple-contrast computed
R M Albrecht1, A Vigil, C R Schermer
1Department of General Surgery, University of New Mexico, Albuquerque, USA.
The American Surgeon
|July 10, 1999
Summary
Triple-contrast computerized tomography (3CT) accurately diagnoses stab wounds to the back/flank in stable patients. This imaging method allows safe triage, reducing hospital length of stay for low-risk cases.
Area of Science:
- Trauma Surgery
- Diagnostic Imaging
- Emergency Medicine
Background:
- Triple-contrast computerized tomography (3CT) is a proposed method for evaluating stab wounds (SWs) to the back/flank.
- It aims to detect high-risk injuries and triage low-risk patients efficiently.
Purpose of the Study:
- To retrospectively review the diagnostic accuracy of 3CT for back/flank SWs.
- To evaluate the potential for decreased hospital length of stay (LOS) in patients with low-risk 3CT scans and no associated injuries.
Main Methods:
- Retrospective review of 79 hemodynamically stable patients with back/flank SWs.
- Analysis of 58 initial 3CT evaluations (44 low-risk, 14 high-risk) and 21 mandatory laparotomies.
Main Results:
- 3CT demonstrated a diagnostic accuracy of 97.9%.
- Significantly shorter LOS (16.5 hours) was observed in patients with low-risk 3CT scans and no associated injuries compared to other groups.
- Patients with low-risk scans and no injuries could be discharged immediately.
Conclusions:
- 3CT is a safe and effective tool for triaging hemodynamically stable patients with back/flank SWs.
- A management strategy utilizing 3CT can significantly decrease LOS for patients with a low incidence of significant injury.
- Observation for 6-24 hours is recommended for patients with potential delayed associated injuries.