Stab wounds to the gluteal region: A management strategy

Objective: To examine the utility of a protocol for treating stab wounds to the gluteal region, These are uncommon and potentially lethal, and the loc ation of injury influences the rate and severity of associated injuries. Th is was a retrospective, uncontrolled study. Methods: Patients who sustained gluteal stab wounds and were treated accord ing to our predetermined protocol that classifies injuries as upper or lowe r zone were reviewed, and associated injuries and outcome were measured. Results: Of 27 gluteal stab wounds in 17 patients, 53% were classified as u pper zone and 47% as lower zone injuries, Sixty-six percent of the upper zo ne injuries had associated neurologic, vascular, or visceral injuries that required invasive procedures or surgery, compared with 12.5% for lower zone injuries (p < 0.05). Conclusion: Upper zone gluteal stab wounds require prompt multisystem evalu ation with mandatory angiography and aggressive management. Lower zone woun ds need observation and repeated evaluations.