Selective clinical management of anterior abdominal stab wounds.

Vassiliki Tsikitis, Walter L. Biffl, Sarah Majercik, David T. Harrington, William G. Cioffi

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39 Scopus citations

Abstract

BACKGROUND: The optimal management of clinically stable patients with anterior abdominal stab wounds (AASWs) is debated. We implemented a protocol of serial clinical assessments to determine the need for laparotomy. The purpose of this study was to determine whether the approach is safe and effective. METHODS: Records of patients sustaining AASWs from 1999 to 2003 were reviewed. RESULTS: Seventy-seven patients sustained AASWs. Twenty-five were taken directly to the operating room because of hypotension (5), evisceration (7), or peritonitis (15). Seventeen patients had diagnostic peritoneal lavage (DPL) for associated thoracoabdominal wounds and 5 had local wound exploration (LWE) off protocol. The remaining 30 patients were managed with serial clinical assessments and were discharged uneventfully. CONCLUSION: Patients sustaining AASWs who present without hypotension, evisceration, or peritonitis may be managed safely under a protocol of serial clinical evaluations. This approach should be compared with LWE/DPL in a prospective, randomized multicenter trial.

Original languageEnglish (US)
Pages (from-to)807-812
Number of pages6
JournalAmerican Journal of Surgery
Volume188
Issue number6
Publication statusPublished - Dec 2004
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Tsikitis, V., Biffl, W. L., Majercik, S., Harrington, D. T., & Cioffi, W. G. (2004). Selective clinical management of anterior abdominal stab wounds. American Journal of Surgery, 188(6), 807-812.