Department of Paediatric Surgery, University of KwaZulu-Natal, South Africa.
University Hospitals Coventry and Warwickshire NHS Trust, United Kingdon.
S Afr J Surg. 2020 Mar;58(1):33-36.
This project aims to review the spectrum and outcome of penetrating trauma in children and adolescents with the objective of defining the extent of the problem and of developing strategies to reduce the incidence and severity of this form of trauma.
All patients less than eighteen years of age who were admitted to the Pietermaritzburg Metropolitan Trauma Service (PMTS) following penetrating trauma between December 2012 and December 2018 were identified from the Hybrid Electronic Medical Registry (HEMR).
During the five-year period under review, a total of 164 patients less than eighteen years of age sustained penetrating trauma and were admitted to the PMTS. There were 138 males and 26 females. The mean age was 13.29 years and the median age 15 years. There were 70 stab wounds (SW) and 73 gunshot wounds (GSW). There were 21 non-intentional impalement injuries. The mean ISS was 9.04 and the median was 9. A total of 155 plain X-rays were performed, 50 CT scans and 51 CT angiograms in this cohort of patients. Only two ultrasound examinations were performed. A total of 76 patients required an operation, which included 50 laparotomies. Of the patients who underwent a laparotomy, 18 required a repeat laparotomy. There were 46 other procedures undertaken in this cohort of patients, which included two thoracotomies, three laparoscopies and two thoracotomies. The median hospital stay was 2 days and 17 (10%) patients required ICU admission and 7 (4%) died.
Penetrating trauma in children and adolescents is associated with significant mortality and morbidity. There are similarities with the management of these injuries in adults, but further work is required to ensure that paediatric management algorithms are evidence based.
本项目旨在回顾儿童和青少年穿透性创伤的范围和结果，目的是确定问题的严重程度，并制定减少这种创伤形式的发生率和严重程度的策略。
从混合电子医疗登记处（HEMR）中确定了 2012 年 12 月至 2018 年 12 月期间因穿透性创伤而入住彼得马里茨堡大都市创伤服务处（PMTS）的所有 18 岁以下患者。
在五年的审查期间，共有 164 名 18 岁以下的患者因穿透性创伤而入住 PMTS。其中有 138 名男性和 26 名女性。平均年龄为 13.29 岁，中位数年龄为 15 岁。有 70 处刺伤（SW）和 73 处枪伤（GSW）。有 21 例非故意的刺穿伤。ISS 平均为 9.04，中位数为 9。在该患者组中总共进行了 155 次普通 X 射线检查，50 次 CT 扫描和 51 次 CT 血管造影。仅进行了 2 次超声检查。共有 76 名患者需要手术，其中包括 50 例剖腹手术。在接受剖腹手术的患者中，有 18 例需要再次剖腹手术。该患者组中还进行了 46 例其他手术，包括 2 例开胸手术，3 例腹腔镜检查和 2 例开胸手术。中位数住院时间为 2 天，17 名（10％）患者需要入住 ICU，7 名（4％）患者死亡。
儿童和青少年的穿透性创伤与显著的死亡率和发病率有关。这些损伤的处理与成年人相似，但需要进一步努力，以确保儿科管理算法基于证据。
