Management of low-velocity, non-gunshot-wound penetrating abdominal injury: have we moved with the times?

BACKGROUND

The incidence of penetrating abdominal injuries in Australia and New Zealand is low. Traditionally, low-velocity, non-gunshot-wound (GSW) penetrating abdominal injuries have been surgically explored. With advances in imaging modalities and laparoscopic techniques, more options now exist to determine the presence or absence of serious intra-abdominal injury. Surgical intervention can often be avoided. We undertook this study to determine whether these options had been reflected in surgical practice and management changed in this population of patients.

METHODS

Retrospective review of trauma patients over the 10-year duration 1996-2005 admitted to Auckland City Hospital Trauma Services. The population of patients were subdivided into two cohorts, an earlier group (1996-2000) and a later group (2001-2005) for comparison purposes.

RESULTS

No statistical significance existed between the two groups in their demographics and treatment approaches.

CONCLUSIONS

Despite the availability of laparoscopic procedures and advanced imaging techniques, surgical practice in a major metropolitan New Zealand hospital had not changed. This may reflect both the success of the earlier treatment guidelines and failure of educational strategies to effect change of practice.