ABDOMINAL STAB WOUNDS - THE ROLE OF SELECTIVE MANAGEMENT

Objective: To investigate the role of a selective approach to the oper ative treatment of abdominal stab wounds. Design: Retrospective study. Setting: University hospital, Turkey. Subjects: 387 patients with sta b wounds of the abdomen, who presented between January 1992 and Januar y 1995. Interventions: After local exploration of the wound, 200 patie nts in whom the wound had penetrated the peritoneum, underwent diagnos tic peritoneal lavage. The lavage fluid was examined for white cells, red cells, and amylase and alkaline phosphatase activity. The severity of the injury was evaluated with the penetrating abdominal trauma ind ex (PATI). Main outcome measures: Morbidity and mortality. Results: Th e main complications were wound infection (n = 15), wound dehiscence ( n = 5), pneumonia (n = 3) and renal failure (n = 1). Five patients die d. The median hospital stay was 6.1 days when patients were operated o n, and 1.5 days when they were not. Conclusions: We managed to minimis e the number of negative and unnecessary laparotomies. We emphasise th at the selective approach may easily be applied in teaching hospitals.