Peritoneal lavage. Reliability of RBC count in patients with stab wounds to the chest.

Two hundred thirteen patients with stab wounds to the lower part of the chest and abdomen were reviewed to determine if a lavage RBC count of 100,000/cu mm was a reasonable figure to permit prompt recognition of injury and to minimize the number of negative operative procedures. There were four (1.9%) false-positive and nine (4.2%) false-negative lavages. Three patients (1.4%) had complications due to delayed operation, including one death (0.47%). Two patients (0.9%) had hollow viscus injuries; neither involved the colon. Three of the nine patients with injuries had cell counts of less than 1,000/cu mm. The negative cellotomy rate was 4.2%. It was concluded that the number of missed injuries, delayed operative procedures, and complications was sufficiently low enough to continue recommending 100,000 RBCs per cubic millimeter as a safe number to use as an indication for operation.