| Primary repair vs. colostomy for the treatment of penetrating colon injuries. | |
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MedLine Citation:
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PMID: 2591279 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The charts of 81 consecutive patients with penetrating colonic trauma were reviewed. Sixty-five patients were considered for evaluation. Penetrating abdominal trauma index, associated injuries, length of operative procedure, wounding agent, length of hospital stay, method of treatment, and septic complications were evaluated. Twenty-eight patients were treated with colostomy at the site of injury: five with diverting colostomy proximal to repair, 30 with primary repair (either single or multiple injuries), and two with exteriorization and early drop back. Overall septic morbidity was 15 of 65 (23 percent) patients. No statistically significant difference was found in morbidity between colostomy, 9 of 33 (27 percent), and primary repair, 6 of 30 (20 percent). The two patients with exteriorized repairs had no morbidity. No deaths were reported among the 65 patients studied. Thirty-two of the 33 (97 percent) colostomies were later closed with morbidity in 7 of 32 (22 percent). The mean length of stay for primary repair patients was 10.3 +/- 2.8 days and for colostomy patients, 25.7 +/- 3.8 days, counting days for both initial and colostomy closure admissions (P less than .05). Colostomy was not mandated by anatomic location or number of colonic injuries, circumference of colonic wall involved, presence of fecal contamination, or involvement of mesenteric blood supply. This study indicates that primary repair does not carry an increased risk of septic complications and saves the patient the significant risk and increased hospital stay of colostomy closure. Prospective studies addressing this area are indicated. |
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Authors:
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C A Ridgeway; S B Frame; J C Rice; G A Timberlake; N E McSwain; M D Kerstein |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 32 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 1989 Dec |
Date Detail:
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Created Date: 1990-01-19 Completed Date: 1990-01-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1046-9 Citation Subset: IM |
Affiliation:
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Department of General Surgery, University of Kansas, Kansas City. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Colon / injuries*, surgery Colostomy* Female Humans Length of Stay Male Prognosis Reoperation Retrospective Studies Risk Factors Surgical Wound Infection Time Factors Trauma Severity Indices Wounds, Gunshot / surgery* Wounds, Stab / surgery* |
| Comments/Corrections | |
Comment In:
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Dis Colon Rectum. 1990 Apr;33(4):354
[PMID:
2323289
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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