Utility of the biofragmentable anastomotic ring in traumatic small bowel injury.
OBJECTIVE
To evaluate the use of the 25 mm Biofragmentable Anastomotic Ring (BAR) in traumatic small bowel injury.


METHODS
In a one year prospective, nonrandomized study, 18 patients (x age = 25 yrs) with penetrating small bowel injury had 25 BAR devices placed to restore intestinal continuity. Using one-way analysis of variance, this group was compared to 63 historical controls (x age = 27 yrs) with small bowel trauma 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 deaths 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.
Fansler
R F
RF
Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana 70112-2699.
Mero
K
K
Steinberg
S M
SM
McSwain
N E
NE
Flint
L M
LM
Ferrara
J J
JJ
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D001672:Biocompatible Materials; D004867:Equipment Design; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007421:Intestine, Small / Q000293:injuries* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D019736:Prostheses and Implants; D017792:Surgical Stapling; D013536:Suture Techniques; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications
D001672:Biocompatible Materials