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Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent?
Hollow viscus injuries represent a significant portion of overall lesions sustained during penetrating trauma. Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring dam...
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Published in: | Colombia médica (Cali, Colombia) Colombia), 2021-04, Vol.52 (2), p.e4114425 |
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creator | Ordoñez, Carlos Alberto Parra, Michael Caicedo, Yaset Padilla, Natalia Angamarca, Edison Serna, Jose Julian Rodriguez, Fernando Garcia, Alberto Salcedo, Alexander Pino, Luis Fernando Gonzalez Hadad, Adolfo Herrera, Mario Alain Quintero, Laureano Hernandez, Fabian Franco, Maria Josefa Aristizabal, Gonzalo Toro, Luis Eduardo Guzman, Monica Coccolini, Federico Ferrada, Ricardo Ivatury, Rao |
description | Hollow viscus injuries represent a significant portion of overall lesions sustained during penetrating trauma. Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring damage control surgery. The traditional surgical dogma of ostomy has proven to be unnecessary and, in many instances, actually increases morbidity. The aim of this article is to delineate the experience obtained in the management of combined hollow viscus injuries of patients suffering from penetrating trauma. We sought out to determine if primary and/or deferred bowel injury repair via anastomosis is the preferred surgical course in patients suffering from combined small and large bowel penetrating injuries. Our experience shows that more than 90% of all combined penetrating bowel injuries can be managed via primary or deferred anastomosis, even in the most severe cases requiring the application of damage control principles. Applying this strategy, the overall need for an ostomy (primary or deferred) could be reduced to less than 10%. |
doi_str_mv | 10.25100/cm.v52i2.4425 |
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Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring damage control surgery. The traditional surgical dogma of ostomy has proven to be unnecessary and, in many instances, actually increases morbidity. The aim of this article is to delineate the experience obtained in the management of combined hollow viscus injuries of patients suffering from penetrating trauma. We sought out to determine if primary and/or deferred bowel injury repair via anastomosis is the preferred surgical course in patients suffering from combined small and large bowel penetrating injuries. Our experience shows that more than 90% of all combined penetrating bowel injuries can be managed via primary or deferred anastomosis, even in the most severe cases requiring the application of damage control principles. 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title | Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent? |
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