PENETRATING ABDOMINAL-TRAUMA

Infection is a major cause of morbidity and mortality following penetr ating abdominal trauma. Antibiotics are routinely used although their effectiveness has never been evaluated in a placebo-controlled randomi sed trial, and they have never been shown to reduce the incidence of p ost injury intra-abdominal, as opposed to wound, infections. The avail able evidence indicates that a single preoperative dose of an appropri ate antibiotic is adequate prophylaxis for penetrating abdominal injur ies. Postoperative antibiotics should be reserved for ''late'' (>12 ho urs) operations for enteric perforations. The optimal duration of trea tment under these circumstances is not well established. Fever and leu cocytosis are poor indicators of the need for continued postoperative administration in the severely traumatised patient.