COMPLICATIONS OF NEGATIVE LAPAROTOMY FOR TRUNCAL STAB WOUNDS

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.