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Treatment of rectal war wounds
Oscar J F van Waes1, J A Halm1, J Vermeulen1
1Department of Trauma Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands.
Journal of the Royal Army Medical Corps
|October 11, 2013
Summary
Military combat settings present unique challenges for treating penetrating rectal injuries (PRI). Successful management involves tailored surgical approaches, including debridement, vacuum therapy, and colostomy, based on injury severity.
Area of Science:
- Trauma surgery
- Colorectal surgery
- Military medicine
Background:
- Penetrating rectal injuries (PRI) lack standardized civilian treatment protocols.
- High-energy transfer PRI, common in military settings, complicates management.
- Effective PRI treatment strategies require adaptation to combat environments.
Observation:
- Three cases of PRI treated in a deployed combat zone were analyzed.
- Management strategies successfully employed in these cases are detailed.
- Literature on PRI management was reviewed and discussed.
Findings:
- Repetitive debridement and vacuum-assisted closure therapy are beneficial for significant soft tissue damage.
- The choice between loop or end colostomy depends on the extent of anal sphincter complex injury.
- A tailored approach to PRI management is crucial in combat settings.
Implications:
- Findings offer insights into managing complex PRI in austere environments.
- The study highlights the need for adaptable surgical protocols for combat casualties.
- Improved understanding can enhance outcomes for patients with high-energy rectal trauma.
Keywords:
ACCIDENT & EMERGENCY MEDICINEORTHOPAEDIC & TRAUMA SURGERYPLASTIC & RECONSTRUCTIVE SURGERYTRAUMA MANAGEMENTWOUND MANAGEMENTMore Related Videos
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