title: Comparison of conservative management and laparotomy in the management of stable patients with abdominal stab wound.
abstract: BACKGROUND
  The management of the hemodynamically stable patients with penetrating abdominal stab wounds is a problematic issue among trauma surgeons.
  
  
  METHODS
  In a retrospective study, we analyzed stable patients with anterior abdominal stab wound from August 2009 to 2010. The patients who were hemodynamically unstable or had developed peritonitis were excluded. In our center, the patients are treated through conservative or operative management depending on the protocol of management of the stable penetrating abdominal stab wound in our center. We compared the effectiveness, mean duration of hospital admission, and the time of starting diet in 2 groups.
  
  
  RESULTS
  There were 99 cases including 47 patients in the conservative group and 52 in the laparotomy group. The laparotomy was negative in 73% and positive in 27% of the patients. In the conservative group, all the patients remained asymptomatic and stable except for 6 patients who needed subsequent laparotomy. The maximum period between admission and delayed laparotomy in these 6 patients was 17 hours. The mean length of hospital stay and the time of starting diet were 70.4 vs 43 hours and 42.3 vs 30.6 hours in the operative group and conservative group, respectively. P < .05 was considered significant.
  
  
  CONCLUSIONS
  Our study showed that conservative management of asymptomatic and stable patients with anterior abdominal stab wound with physical examination can decrease the rate of normal laparotomy and the length of hospitalization and help to start diet earlier. This study made this hypothesis that after 17 hours of observation, diet can be started for the stable asymptomatic patients.
authors.affiliation: Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Paydar
authors.forename: Roohollah
authors.initials: R
authors.lastname: Salahi
authors.forename: Forough
authors.initials: F
authors.lastname: Izadifard
authors.forename: Zahra
authors.initials: Z
authors.lastname: Jaafari
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Abbasi
authors.forename: Armaghan
authors.initials: A
authors.lastname: Eshraghian
authors.forename: Seied-Vahid
authors.initials: SV
authors.lastname: Hosseini
authors.forename: Farnaz
authors.initials: F
authors.lastname: Farrokhnia
authors.forename: Yalda
authors.initials: Y
authors.lastname: Golshan
authors.forename: Shahram
authors.initials: S
authors.lastname: Bolandparvaz
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery* / Q000628:therapy; D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014951:Wounds, Stab / Q000601:surgery* / Q000628:therapy