Primary repair of colonic injuries: a clinical evaluation

Fifty-seven patients with colonic injuries were treated by primary repair with or without exteriorization. Forty-six of these had other associated major intra-abdominal, intrathoracic, and musculoskeletal injuries. All had minimal contamination of the peritoneal cavity and were operated upon within 6 hours of injury. None showed any evidence of anastomical leakage or breakdown. Minor complications occurred in 12 patients (21%). Two deaths (3.5%) resulted, but neither was attributable to the repair of the colon; one died from renal failure and the other from pulmonary embolism. On the basis of this study, it is concluded that most isolated injuries of the colon resulting from low-velocity bullets and sharp objects can be closed primarily if peritoneal contamination is minimal and antibiotics are administered immediately after injury, during operation, and post-operatively.