A. Leppaniemi et al., COMPLICATIONS OF NEGATIVE LAPAROTOMY FOR TRUNCAL STAB WOUNDS, The journal of trauma, injury, infection, and critical care, 38(1), 1995, pp. 54-58
In a retrospective study of 459 patients undergoing mandatory explorat
ive laparotomy for truncal stab wounds, 172 (37%) negative laparotomie
s were identified, divided in two groups: group I (n = 147) without, a
nd group IT (n = 25) with associated extra-abdominal injuries or surgi
cal procedures other than laparotomy. One patient (0.6%) died of assoc
iated mediastinal vascular injuries. The overall postoperative morbidi
ty rate was 21%, 17% in group I, and 44% in group II (p < 0.001). The
excess morbidity in group II was caused by pulmonary complications ass
ociated with a thoracic injury or procedure. In group I, the complicat
ions were not severe, prolonging the mean hospital stay by 4.6 days. I
t is concluded that mandatory laparotomy for truncal stab wounds leads
to an unnecessary operation in about 40% of cases, with a 20% morbidi
ty rate associated with the laparotomy itself. Although the complicati
ons are not severe, the results should be assessed against the safety
and accuracy of the selective management of abdominal stab wounds.