Management of haemodynamically stable patients with penetrating abdominal stab injuries: Review of practice at an Australian major trauma centre

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Abstract

Introduction: The management of haemodynamically stable patients who present following a penetrating abdominal injury (PAI) remains variable between mandatory surgical exploration and more selective non-operative approaches. The primary aim of this study was to assess compliance with an algorithm guiding selective non-operative management of haemodynamically stable patients with PAI. The secondary aim was to examine the association between compliance and unnecessary laparotomies. Methods: This was a retrospective cohort study involving all patients with PAI that presented to a major trauma centre from January 2007 to December 2011. Data were extracted from the trauma registry and patients’ electronic medical records. Results: There were 189 patients included in the study, of which 79 (41.8 %) patients complied with the algorithm. The laparotomy rate in the setting of algorithm compliance was significantly lower than algorithm non-compliance (12.7 vs. 68.2 %; p < 0.01) as were unnecessary laparotomy rates (0 vs. 33.3 %; p = 0.03). Conclusion: Among haemodynamically stable patients presenting with PAI, compliance with an algorithm guiding selective non-operative management was low, but associated with lower laparotomy and lower unnecessary laparotomy rates. Improved compliance with algorithms directed towards selective non-operative management of PAI should be encouraged with stringent vigilance towards patient safety.

Original languageEnglish
Pages (from-to)671-675
Number of pages5
JournalEuropean Journal of Trauma and Emergency Surgery
Volume42
Issue number6
DOIs
Publication statusPublished - 1 Dec 2016

Keywords

  • Abdominal trauma
  • General surgery
  • Trauma

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