The utility of presacral drainage in penetrating rectal injuries in adult and pediatric patients
| Autor: | Thomas M. Beazley, Regan F. Williams, Peter M. Hammer, Brent E. Cleveland, Troy A. Markel, Stephanie A. Savage, Sina Khaneki, Kate B. Savoie |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Wounds Penetrating Stratified analysis 03 medical and health sciences Young Adult 0302 clinical medicine Primary outcome medicine Humans Abscess Child Retrospective Studies Adult patients business.industry Rectum 030208 emergency & critical care medicine medicine.disease Tennessee Surgery 030220 oncology & carcinogenesis Drainage Female business Complication Adult level Penetrating trauma Pediatric trauma |
| Zdroj: | The Journal of surgical research. 219 |
| ISSN: | 1095-8673 |
| Popis: | With changing weaponry associated with injuries in civilian trauma, there is no clinical census on the utility of presacral drainage (PSD) in penetrating rectal injuries (PRIs), particularly in pediatric patients.Patients with PRI from July 2004-June 2014 treated at two free-standing children's hospitals and two adult level 1 trauma centers were compared by age (pediatric patients ≤16 years) and PSD. A stratified analysis was performed based on age. The primary outcome was pelvic/presacral abscess.We identified 81 patients with PRI; 19 pediatric, 62 adult. Forty patients had PSD; only three pediatric patients had a drain. Adult patients were more likely to have sustained gunshot wounds (84%), whereas pediatric patients were more likely to sustain impalement injuries (59%). Pediatric patients were more likely to have distal extraperitoneal injuries (56% versus 27% in adults, P = 0.03). PSD was more common in adult patients (59% versus 14%, P = 0.0004), African-Americans (71% versus 11% Caucasian, P 0.01), and those sustaining gun shot wounds (63% versus 18% impalement, P 0.01); only race remained significant in stratified analysis for both adult and pediatric patients. There were three cases of pelvic/presacral abscess, all in the adult patients (P = 0.31); one patient with PSD and two without PSD (P = 0.58). In stratified analysis, there were no differences in any infectious complication between those with and without PSD.Pelvic/presacral abscess is a rare complication of PRI, especially in pediatric patients. PSD is not associated with decreased rates of infectious complications and may not be necessary in the treatment of PRI. |
| Databáze: | OpenAIRE |
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