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Review Multicenter Study Observational Study
Damage control surgical management of combined small and large bowel injuries in penetrating trauma: Are ostomies still pertinent?
- Carlos A Ordoñez, Michael W Parra, Yaset Caicedo, Natalia Padilla, Edison Angamarca, José Julián Serna, Fernando Rodríguez-Holguín, Alberto García, Alexander Salcedo, Luis Fernando Pino, Adolfo González-Hadad, Mario Alain Herrera, Laureano Quintero, Fabian Hernández, María Josefa Franco, Gonzalo Aristizábal, Luis Eduardo Toro, Mónica Guzmán-Rodríguez, Federico Coccolini, Ricardo Ferrada, and Rao Ivatury.
- Fundación Valle del Lili, Department of Surgery, Division of Trauma and Acute Care Surgery. Cali, Colombia.
- Colomb Medica. 2021 Apr 27; 52 (2): e4114425.
AbstractHollow viscus injuries represent a significant portion of overall lesions sustained during penetrating trauma. Currently, isolated small or large bowel injuries are commonly managed via primary anastomosis in patients undergoing definitive laparotomy or deferred anastomosis in patients requiring damage control surgery. The traditional surgical dogma of ostomy has proven to be unnecessary and, in many instances, actually increases morbidity. The aim of this article is to delineate the experience obtained in the management of combined hollow viscus injuries of patients suffering from penetrating trauma. We sought out to determine if primary and/or deferred bowel injury repair via anastomosis is the preferred surgical course in patients suffering from combined small and large bowel penetrating injuries. Our experience shows that more than 90% of all combined penetrating bowel injuries can be managed via primary or deferred anastomosis, even in the most severe cases requiring the application of damage control principles. Applying this strategy, the overall need for an ostomy (primary or deferred) could be reduced to less than 10%.Copyright © 2021 Colombia Medica.
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