title: Selective surgical management of penetrating anterior abdominal wounds at the Angau Memorial Hospital: a prospective study.
abstract: Trauma is a leading cause of admissions to the surgical ward in Papua New Guinea (PNG), accounting for about 35% of cases. Of these, 15% of cases are abdominal injuries, of which 19% are penetrating injuries. Selective surgical management of patients with a low-velocity anterior abdominal wound (AAW) is beneficial in some patients.
  
  
  OBJECTIVE
  To determine if selective surgical management is a viable therapeutic option in PNG.
  
  
  METHODS
  A non-random prospective study of consecutive cases was done on 60 patients with an AAW based entirely on clinical symptoms and signs. The outcome measures were length of hospital stay, morbidity and mortality. Data were analysed using SPSS 10.0 for Windows and Microsoft Excel.
  
  
  RESULTS
  Immediate laparotomy was done on 24 (40%) of cases and 36 (60%) had nonoperative conservative management, of which 6 (17%) failed and went on to have laparotomy on demand. The average hospital stay was 4 days shorter (p = 0.0001) for the nonoperative group, which had significantly fewer complications (p = 0.01). No deaths were recorded in either of the two groups of patients.
  
  
  CONCLUSIONS
  Selective nonoperative management of stable patients with an AAW with or without omental signs is a safe therapeutic option in PNG.
authors.affiliation: Surgery Unit, Angau Memorial Hospital, PO Box 457, Lae, Morobe Province 411, Papua New Guinea.
authors.forename: Kevin
authors.initials: K
authors.lastname: Lapu
authors.forename: M
authors.initials: M
authors.lastname: Mathew
authors.forename: G
authors.initials: G
authors.lastname: Gende
authors.forename: I
authors.initials: I
authors.lastname: Kevau
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000401:mortality / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007813:Laparotomy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010219:Papua New Guinea; D018579:Patient Selection; D010538:Peritonitis / Q000209:etiology / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome; D014950:Wounds, Penetrating / Q000150:complications / Q000401:mortality / Q000601:surgery*; D055815:Young Adult