SURVEYED OPINION OF AMERICAN TRAUMA SURGEONS IN MANAGEMENT OF COLON INJURIES

Background: Primary repair or resection and anastomosis of colon wound s have been advocated in many recent studies, but the proportion of tr auma surgeons accepting these recommendations is unknown, Objective: T o determine the current preferences of American trauma surgeons for co lon injury management, Methods: Four hundred forty-nine members of the American Association for the Surgery of Trauma were surveyed regardin g their preferred management of eight types of colon wounds among thre e options: diverting colostomy (DC), primary repair (PR), or resection and anastomosis (RA), The influence of selected patient factors and s urgeons' characteristics on the choice of management was also surveyed , Results: Seventy-three percent of surgeons completed the survey, Nin ety-eight percent chose PR for at least one type of injury, Thirty per cent never selected DC, High-velocity gunshot wound was the only injur y for which the majority (54%) would perform DC, More than 55% of the surgeons favored RA when the isolated colon injury was a contusion wit h possible devascularization, laceration greater than 50% of the diame ter, or transection, Surgeons who managed five or fewer colon wounds p er year chose DC more frequently (p < 0.001) and PR less frequently (p < 0.001) than surgeons who managed six or more colon wounds per year, Conclusion: The prevailing opinion of trauma surgeons favors primary repair or resection of colon injuries, including anastomosis of unprep ared bowel, Surgeons who manage fewer colon wounds prefer colostomy mo re frequently.