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首页> 外文期刊>The American Journal of Surgery >Local wound exploration remains a valuable triage tool for the evaluation of anterior abdominal stab wounds.
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Local wound exploration remains a valuable triage tool for the evaluation of anterior abdominal stab wounds.

机译：局部伤口探查仍然是评估腹部前刺伤的有价值的分类工具。

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摘要

BACKGROUND: Recent guidelines do not support local wound exploration (LWE) or diagnostic peritoneal lavage (DPL) in the evaluation of patients with anterior abdominal stab wounds (AASWs), favoring computed tomography scanning or serial examinations. In patients without immediate indications for laparotomy, we hypothesized that LWE/DPL would identify patients requiring surgery while limiting unnecessary hospital admissions. METHODS: Patients sustaining penetrating trauma at our level I trauma center over a 3-year period were reviewed. RESULTS: During the study period, 139 patients with AASW followed our LWE/DPL algorithm. Fifty-six patients had LWE without fascial penetration: 46 were discharged immediately, 10 required admission. Fifty-eight patients had fascial penetration on LWE but negative DPL: 37 were observed for less than 24 hours, 19 were observed for more than 24 hours, and 2 patients developed peritonitis requiring exploration. Twenty-five patients had positive LWE/DPL: 13 had therapeutic laparotomy, 12 had nontherapeutic laparotomy. CONCLUSIONS: Only 11% of patients with AASWs without overt indication for laparotomy require surgical care. LWE remains a valid method to exclude intra-abdominal injury and to eliminate hospitalization in more than one third of AASW patients.
机译：背景：最近的指南在评估前腹部刺伤（AASW）患者时不支持局部伤口探查（LWE）或诊断性腹膜灌洗（DPL），而建议使用计算机断层扫描或连续检查。在没有立即进行剖腹手术指征的患者中，我们假设LWE / DPL可以识别需要手术的患者，同时限制不必要的住院治疗。方法：回顾了在我们I级创伤中心持续3年的持续性创伤的患者。结果：在研究期间，有139例AASW患者遵循了我们的LWE / DPL算法。 56例LWE患者无筋膜穿刺：立即出院46例，需要入院10例。 58名患者在LWE上筋膜穿刺，但DPL阴性：观察不到24小时的37例，观察超过24小时的19例，以及2例需要探查的腹膜炎患者。 25例LWE / DPL阳性：13例行开腹治疗，12例行非治疗开腹。结论：只有11％的AASW患者没有明确的剖腹手术指征需要手术治疗。 LWE仍然是排除腹内损伤并消除三分之一以上AASW患者住院的有效方法。

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