title: Primary repair or fecal diversion for colorectal injuries after blast: a medical review.
abstract: Blast injury is a frequent cause of injury during armed conflicts, and the force of a blast can cause closed colorectal injury and perforation.1 After identification of a blast-related colorectal injury, the surgical options are primary repair or fecal diversion with the option for secondary repair. This structured review was conducted to determine which patients could be treated with primary repair (PR) or with fecal diversion. The review method followed the Prisma Statement method for medical systematic review. All data from the relevant articles were collected in a single database. Articles took into account wars in Bosnia, Iraq and Afghanistan from January 1993 through November 2012. The review was limited due to lack of reported data, hence qualitative analysis was the main review method. The review showed that for patients who do not have associated intra-abdominal injuries (diaphragm, stomach, pancreas, spleen, or kidney) or hemodynamic instability, PR did not result in an increase of complications or mortality.
authors.affiliation: 1Università Vita-Salute San Raffaele,Milan,Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: Bortolin
authors.affiliation: 1Università Vita-Salute San Raffaele,Milan,Italy.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Baldari
authors.affiliation: 1Università Vita-Salute San Raffaele,Milan,Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Sabbadini
authors.affiliation: 3Department of Surgery,BARC Hospital,Mumbai,India.
authors.forename: Nobhojit
authors.initials: N
authors.lastname: Roy
mesh_terms: D000007:Abdominal Injuries / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery*; D000328:Adult; D055826:Afghan Campaign 2001-; D000346:Afghanistan / Q000453:epidemiology; D001753:Blast Injuries / Q000150:complications* / Q000453:epidemiology / Q000601:surgery*; D017522:Bosnia and Herzegovina / Q000453:epidemiology; D003106:Colon / Q000293:injuries*; D003125:Colostomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007493:Iraq / Q000453:epidemiology; D054542:Iraq War, 2003-2011; D008297:Male; D008889:Military Personnel / Q000706:statistics & numerical data