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[Management of abdominal stab wounds]
S P Mönig1, U Hahn, J Isenberg
1Chirurgische Universitätsklinik zu Köln, Bundesrepublik Deutschland.
Wiener Klinische Wochenschrift
|January 1, 1996
Summary
Laparotomy remains the preferred treatment for penetrating abdominal trauma, even for stab wounds. This retrospective study found it safe and effective, with a low mortality rate and minimal late complications after negative procedures.
Area of Science:
- Trauma Surgery
- Surgical Management
- Emergency Medicine
Context:
- Management of abdominal stab wounds is controversial.
- Laparotomy is generally accepted for abdominal shot wounds.
- Retrospective analysis of 30 cases of abdominal stab wounds treated with laparotomy between 1985 and 1993.
Purpose:
- To evaluate the efficacy and safety of laparotomy in managing penetrating abdominal trauma, specifically stab wounds.
- To analyze outcomes including negative laparotomy rates, injury types, and mortality.
- To assess long-term outcomes following negative laparotomies.
Summary:
- Laparotomy was performed in 30 patients with abdominal stab wounds (24 assault, 6 suicidal).
- Negative laparotomy rate was 27%. Common injuries included vessels (n=12) and intestines (n=9).
- Mortality rate was 6.7%, with no deaths attributed to negative laparotomy. No late-onset disorders were observed after negative laparotomies during a mean 54-month follow-up.
Impact:
- Laparotomy is favored for penetrating abdominal trauma due to limited diagnostic accuracy for intestinal injuries and low morbidity of negative laparotomies.
- Supports the continued use of laparotomy in cases of suspected internal injury.
- Highlights the safety profile of exploratory laparotomy in trauma patients.