Prevention of infections following penetrating abdominal trauma.
A major problem for patients who survive a traumatic injury is morbidity due to infectious complications; this risk increases when there is injury to the liver, pancreas, or colon, the abdominal trauma index is > 25, and/or surgery is prolonged. For major injuries of either the liver or pancreas, the use of closed suction drainage decreases the risk of infection; sump drainage should be avoided. Most penetrating colon injuries can be managed with primary repair or resection and anastomosis, unless there is an underlying medical condition or a need for massive transfusions. For gunshot wounds penetrating the colon, removal of retained missiles should be attempted because these increase the risk of abscess. A brief course of appropriate antibiotic treatment should be initiated as soon as possible after wounding and should be continued for 24 hours. Prolonged courses of antibiotic provide no added benefits.
Fabian
T C
TC
Presley Regional Trauma Center, Memphis, Tennessee.
D000007:Abdominal Injuries / Q000382:microbiology* / Q000601:surgery; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003106:Colon / Q000293:injuries; D006801:Humans; D008099:Liver / Q000293:injuries; D010179:Pancreas / Q000293:injuries; D012307:Risk Factors; D014946:Wound Infection / Q000517:prevention & control*; D014950:Wounds, Penetrating / Q000382:microbiology* / Q000517:prevention & control / Q000601:surgery
D000900:Anti-Bacterial Agents