Abdominal stab wounds: the role of selective management.

OBJECTIVE

To investigate the role of a selective approach to the operative treatment of abdominal stab wounds.

DESIGN

Retrospective study.

SETTING

University hospital, Turkey.

SUBJECTS

387 patients with stab wounds of the abdomen, who presented between January 1992 and January 1995.

INTERVENTIONS

After local exploration of the wound, 200 patients in whom the wound had penetrated the peritoneum, underwent diagnostic peritoneal lavage. The lavage fluid was examined for white cells, red cells, and amylase and alkaline phosphatase activity. The severity of the injury was evaluated with the penetrating abdominal trauma index (PATI).

MAIN OUTCOME MEASURES

Morbidity and mortality.

RESULTS

The main complications were wound infection (n=15), wound dehiscence (n=5), pneumonia (n=3) and renal failure (n=1). Five patients died. The median hospital stay was 6.1 days when patients were operated on, and 1.5 days when they were not.

CONCLUSIONS

We managed to minimise the number of negative and unnecessary laparotomies. We emphasise that the selective approach may easily be applied in teaching hospitals.