Evidence map›Paper›PMID 38888788›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2024

A decade long overview of damage control laparotomy for abdominal gunshot wounds.

Reuben He, Victor Kong, Jonathan Ko, Anantha Narayanan, Howard Wain, John Bruce, Grant Laing, Vassil Manchev, Wanda Bekker, Damian Clarke

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

10 authors.

Reuben HeDepartment of Surgery, The University of Auckland, Auckland, New Zealand. rhe351@aucklanduni.ac.nz.
Victor KongDepartment of Surgery, University of the Witwatersrand, Johannesburg, South Africa.
Jonathan KoDepartment of Surgery, The University of Auckland, Auckland, New Zealand.
Anantha NarayananDepartment of Surgery, Wellington Hospital, Wellington, New Zealand.
Howard WainDepartment of Surgery, University of KwaZulu Natal, Durban, South Africa.
John BruceDepartment of Surgery, University of KwaZulu Natal, Durban, South Africa.
Grant LaingDepartment of Surgery, University of KwaZulu Natal, Durban, South Africa.
Vassil ManchevDepartment of Surgery, University of KwaZulu Natal, Durban, South Africa.
Wanda BekkerDepartment of Surgery, University of KwaZulu Natal, Durban, South Africa.
Damian ClarkeDepartment of Surgery, University of the Witwatersrand, Johannesburg, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeOver the last three decades, damage control laparotomy (DCL) has become important in the management of abdominal gunshot wounds (GSW). This paper reviews the experience of a single institution over a decade with the use of DCL for GSW of the abdomen.

methodsLongitudinal data (2013-2022) was collected from the Hybrid Electronic Medical Registry database to identify all patients with an abdominal GSW over the study period. The data was stratified based on patients who underwent DCL and those who did not. Descriptive analysis was completed to summarise the raw data. Univariate and multivariate analysis was completed to identify variables associated with undergoing DCL.

resultsThere were 135 patients (32%) who underwent DCL and 290 patients (68%) who did not. Colonic, small bowel, mesenteric, hepatic, pancreatic and intra-abdominal vessel injuries were associated with the need for DCL (P<0.05). In total, 85 of the 135 (63%) patients who underwent DCL required more than one damage control technique. There were 45 (33%) mortalities in the DCL group compared to 16 mortalities (6%) in the non-DCL group (P<0.001).

conclusionOne third of patients who underwent a laparotomy following a gunshot wound to the abdomen had a DCL. The indications for DCL include both physiological criteria and injury patterns. DCL is associated with significant morbidity and mortality. Efforts need to be directed towards refining the indications for DCL in this group of patients to prevent inappropriate application of this potentially lifesaving technique.

Indexed as

Abdominal InjuriesLaparotomyWounds, GunshotAdultFemaleHumansInjury Severity ScoreMaleMiddle AgedRegistriesRetrospective StudiesAbdominal injuryGunshot woundLaparotomySurgeryTrauma

Identifiers

PMID38888788

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.