title: Selective non-operative management of penetrating abdominal injury in Great Britain and Ireland: survey of practice.
abstract: BACKGROUND
  The selective non-operative management of penetrating abdominal injury is gaining increasing acceptance. In Great Britain and Ireland, the management of trauma remains the responsibility of general surgeons. This study appraises the acceptance and utilisation of selective non-operative management strategies by British and Irish general surgeons, compared with trauma surgeons in the United States of America.
  
  
  METHODS
  Electronic questionnaire survey of British and Irish consultant general surgeons and trauma surgeons in the United States of America.
  
  
  RESULTS
  139 British and Irish general surgeons and 75 US trauma surgeons completed the survey. 84.3% of British and Irish general surgeons and 94.4% of US trauma surgeons practise selective non-operative management of abdominal stab wounds, and 14.0% and 74.3% practise selective non-operative management of abdominal gunshot wounds. The management of those British and Irish surgeons who do practise selective non-operative management is broadly similar to that of US trauma surgeons, with the exception of the use of laparoscopy to examine the left hemidiaphragm following thoracoabdominal injuries, which is employed by fewer British and Irish general surgeons than US trauma surgeons.
  
  
  CONCLUSIONS
  The selective non-operative management of abdominal stab wounds is generally accepted by British and Irish general surgeons. In contrast, few British and Irish surgeons are comfortable with non-operatively managing patients with abdominal gunshot wounds, reflecting both the rarity of this type of injury, and surgeons' training and experience. This proportion is unlikely to change until the management of torso trauma is recognised as a specialty, and services are concentrated in regional centres.
authors.affiliation: Department of Surgery & Department of Intensive Care Medicine, Aberdeen Royal Infirmary, Foresterhill, Aberdeen AB25 2ZN, UK. j.o.jansen@gmx.com
authors.forename: J O
authors.initials: JO
authors.lastname: Jansen
authors.forename: K
authors.initials: K
authors.lastname: Inaba
authors.forename: S B
authors.initials: SB
authors.lastname: Rizoli
authors.forename: K D
authors.initials: KD
authors.lastname: Boffard
authors.forename: D
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000601:surgery*; D000328:Adult; D000368:Aged; D005260:Female; D013502:General Surgery / Q000379:methods / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D010535:Laparoscopy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014948:Wounds, Gunshot / Q000453:epidemiology / Q000601:surgery*; D014951:Wounds, Stab / Q000453:epidemiology / Q000601:surgery*