Comparison of conservative management and laparotomy in the management of stable patients with abdominal stab wound
| Autor: | Shahram Bolandparvaz, Farnaz Farrokhnia, Armaghan Eshraghian, Seied-vahid Hosseini, Shahram Paydar, Yalda Golshan, Forough Izadifard, Hamid Reza Abbasi, Zahra Jaafari, Roohollah Salahi |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Conservative management medicine.medical_treatment Peritonitis Physical examination Abdominal Injuries Wounds Stab Asymptomatic Hemodynamically stable Laparotomy medicine Humans Stab wound Retrospective Studies medicine.diagnostic_test business.industry Retrospective cohort study General Medicine Length of Stay medicine.disease Surgery Treatment Outcome Anesthesia Emergency Medicine Female medicine.symptom business |
| Zdroj: | The American Journal of Emergency Medicine. 30:1146-1151 |
| ISSN: | 0735-6757 |
| Popis: | Introduction 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 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. |
| Databáze: | OpenAIRE |
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