UTILITY OF THE BIOFRAGMENTABLE ANASTOMOTIC RING IN TRAUMATIC SMALL-BOWEL INJURY

Objective: To evaluate the use of the 25 mm Biofragmentable Anastomoti c Ring (BAR) in traumatic small bowel injury. Methods: In a one year p rospective, non-randomized study, 18 patients (x age = 25 yrs) with pe netrating small bowel injury had 25 BAR devices placed to restore inte stinal continuity. Using one-way analysis of variance, this group was compared to 63 historical controls (x age = 27 yrs) with small bowel t rauma who had either sutured or stapled anastomoses (SSA), with regard to Penetrating Abdominal Trauma Index (PATI) score, time until return of bowel function, and postoperative morbidity. Results: PATI scores for the two groups were not significantly different (P = 0.099). No de aths in the SSA group (n = 8) or in the BAR group (n = 1) were related to the anastomotic technique. There was no significant difference (P = 0.991) in the rate of post-operative intestinal obstruction between BAR (n = 3) and SSA (n = 8) groups; none of the BAR patients required re-operation. The average length of time for return of bowel function was not significantly different (P = 0.197) between BAR (4.3 days) and SSA (5.8 days) groups. Conclusions: The 25 mm BAR may be used in the repair of traumatic small bowel injury, based upon comparable outcomes when compared with sutured and stapled anastomoses.