Planned reoperation for trauma: a two year experience with 124 consecutive patients

Area of Science:

• Trauma Surgery
• Surgical Critical Care
• Emergency Medicine

Background:

• Severe truncal trauma presents significant management challenges.
• Abbreviated initial surgical procedures are sometimes necessary due to patient instability or technical difficulties.

Purpose of the Study:

• To evaluate the efficacy and outcomes of planned reoperation in patients with severe truncal trauma.
• To identify factors influencing survival in this patient cohort.

Main Methods:

• Retrospective review of 124 patients with severe truncal trauma treated over two years.
• Analysis of initial abbreviated procedures (packing, rapid closure, temporary diversion, etc.) and subsequent planned reoperations.
• Comparison of outcomes between planned and unplanned reoperations, and assessment of missed injuries.

Main Results:

• Penetrating injuries predominated (78%), frequently involving the abdomen/chest.
• 73 patients survived to undergo 101 reoperations; 52 were planned, 21 unplanned.
• Overall mortality was 58%, but survival was significantly better with early termination and planned reoperations.

Conclusions:

• Planned reoperation is a viable strategy for managing severe truncal trauma, offering improved survival.
• Clearer indications and wider adoption of this approach can enhance its effectiveness in critical care settings.