Fascial ultrasound for evaluation of anterior abdominal stab wound injury.
BACKGROUND
Local stab wound (SW) exploration to assess abdominal fascial integrity is a highly invasive procedure frequently performed under demanding circumstances in the Emergency Department (ED). We hypothesized ultrasound (U/S) may be useful in the detection of fascial defects resulting from anterior abdominal stab injury, eliminating the need for local wound exploration


METHODS
Thirty-five hemodynamically normal patients evaluated at a Level I trauma center for anterior abdominal stab wounds were examined by U/S (8 mHz probe) for evidence of fascial violation. All patients were subsequently evaluated by local wound exploration


RESULTS
Fascial U/S had an overall sensitivity of 59% and specificity of 100%, (PPV 100%, NPV 59%) for detection of fascial SW defects compared with local wound exploration. The sensitivity of fascial U/S for stab wound evaluation varied directly with experience of the sonographer


CONCLUSIONS
A positive fascial U/S obviates the need for invasive SW exploration; however, a negative fascial U/S does not preclude the need for local wound exploration. Resident U/S training for specific penetrating injuries may reduce the need for abdominal SW fascial exploration in the ED.
Murphy
Joseph T
JT
University of Texas Southwestern Medical Center, Department of Surgery, Division of Burns, Trauma, Critical Care, Dallas, 75390, USA. Joseph.Murphy@UTSouthwestern.edu
Hall
Jason
J
Provost
David
D
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000328:Adult; D004636:Emergency Service, Hospital; D005205:Fascia / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014193:Trauma Centers; D014463:Ultrasonography; D014951:Wounds, Stab / Q000000981:diagnostic imaging*