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Management of the retained knife blade
Sanju Sobnach1, Andrew Nicol, Hassed Nathire
1Trauma Center, Groote Schuur Hospital, University of Cape Town, Observatory, 7925, Cape Town, South Africa.
World Journal of Surgery
|March 3, 2010
Summary
Retained knife blades are rare injuries. This study found that while simple withdrawal is often possible, retained thoracic blades require prompt management to prevent sepsis, with no deaths reported.
Area of Science:
- Trauma Surgery
- Surgical Management
- Emergency Medicine
Background:
- Retained knife blade injuries are uncommon but significant. Management strategies for these unique cases are crucial.
- This study reviews experience with retained knife blade injuries at a major trauma center.
Purpose of the Study:
- To analyze the management and outcomes of patients with retained knife blades.
- To identify risk factors and optimal treatment approaches for retained knife injuries.
Main Methods:
- Retrospective chart review of patients treated for retained knife blades from January 1996 to December 2007.
- Inclusion of clinical and radiological assessments for all patients.
- Analysis of surgical approaches, complications, and patient outcomes.
Main Results:
- Thirty-three patients with retained knife blades were identified, with thorax being the most common entry site (40%).
- Most patients (91%) were hemodynamically stable; simple withdrawal was successful in 58%, with a low bleeding risk (5%).
- Thirteen patients (40%) required open surgery, and retained thoracic blades were linked to postoperative sepsis (P = 0.0054); no deaths occurred.
Conclusions:
- Careful clinical and radiological assessment is vital for all retained knife injuries.
- Simple blade withdrawal is safe in the emergency room if life-threatening injuries are excluded.
- A low threshold for investigating and treating retained intrathoracic blades for sepsis is recommended.
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