Primary closure of battle wounds of the colon: is it an option for the military surgeon?
The management of battle wounds of the colon has been safely established for many years, with primary closure of the wounds being discouraged. More recent work, involving large numbers of patients from civilian trauma centres, has challenged this. The appropriateness of these conclusions for the battle situation is discussed, including the nature of injury, the medical logistics and the combat scenario. Parameters are indicated and guide lines given, incorporating battle-proven military surgical principles and modern trauma experience. This includes damage control and possible primary closure of selected wounds. In this way the military surgeon can take an informed decision in providing optimal care for patients with battle wounds of the colon.
MacFarlane
C
C
Emergency Medical Services Training, Gauteng Provincial Government Health Department, Johannesburg.
Benn
C A
CA
D000714:Anastomosis, Surgical / Q000379:methods; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000293:injuries* / Q000601:surgery*; D003125:Colostomy / Q000379:methods; D003657:Decision Making; D006801:Humans; D007081:Ileostomy / Q000379:methods; D017053:Infection Control / Q000379:methods; D008887:Military Medicine / Q000379:methods*; D008889:Military Personnel; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D013997:Time Factors; D014857:Warfare; D014945:Wound Healing; D014948:Wounds, Gunshot / Q000601:surgery*