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Comparison of conservative management and laparotomy in the management of stable patients with abdominal stab wound.

AbstractINTRODUCTION:
The management of the hemodynamically stable patients with penetrating abdominal stab wounds is a problematic issue among trauma surgeons.
METHODS:
In a retrospective study, we analyzed stable patients with anterior abdominal stab wound from August 2009 to 2010. The patients who were hemodynamically unstable or had developed peritonitis were excluded. In our center, the patients are treated through conservative or operative management depending on the protocol of management of the stable penetrating abdominal stab wound in our center. We compared the effectiveness, mean duration of hospital admission, and the time of starting diet in 2 groups.
RESULTS:
There were 99 cases including 47 patients in the conservative group and 52 in the laparotomy group. The laparotomy was negative in 73% and positive in 27% of the patients. In the conservative group, all the patients remained asymptomatic and stable except for 6 patients who needed subsequent laparotomy. The maximum period between admission and delayed laparotomy in these 6 patients was 17 hours. The mean length of hospital stay and the time of starting diet were 70.4 vs 43 hours and 42.3 vs 30.6 hours in the operative group and conservative group, respectively. P < .05 was considered significant.
CONCLUSION:
Our study showed that conservative management of asymptomatic and stable patients with anterior abdominal stab wound with physical examination can decrease the rate of normal laparotomy and the length of hospitalization and help to start diet earlier. This study made this hypothesis that after 17 hours of observation, diet can be started for the stable asymptomatic patients.
AuthorsShahram Paydar, Roohollah Salahi, Forough Izadifard, Zahra Jaafari, Hamid Reza Abbasi, Armaghan Eshraghian, Seied-Vahid Hosseini, Farnaz Farrokhnia, Yalda Golshan, Shahram Bolandparvaz
JournalThe American journal of emergency medicine (Am J Emerg Med) Vol. 30 Issue 7 Pg. 1146-51 (Sep 2012) ISSN: 1532-8171 [Electronic] United States
PMID22100482 (Publication Type: Comparative Study, Journal Article)
CopyrightCopyright © 2012 Elsevier Inc. All rights reserved.
Topics
  • Abdominal Injuries (surgery, therapy)
  • Adult
  • Female
  • Humans
  • Laparotomy
  • Length of Stay
  • Male
  • Retrospective Studies
  • Treatment Outcome
  • Wounds, Stab (surgery, therapy)

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