title: Evolution-based algorithm for the management of penetrating abdominal stab injury.
abstract: OBJECTIVE
  As an increasing amount of penetrating abdominal stab injuries has been observed in the last few decades, it is important to evaluate the adequacy of the medical systems and surgical education and training to handle this type of injury. The aim of this study was to analyze the outcome of patients with penetrating abdominal stab injuries admitted to the Emergency Unit and to evaluate the effects of using a new treatment algorithm.
  
  
  METHODS
  From January 2009 to April 2009, a standardized education and training system for the surgical team was implemented in order to improve the emergency medical care system. From April 2009 to April 2011, 106 patients with the diagnosis of a penetrating abdominal stab injury were prospectively included in the study.
  
  
  RESULTS
  The cohort included 98 males and the mean age was 29.40 ± 10.9 years. Eighty-two percent of the patients were managed conservatively, whereas 18 % underwent surgery. Based on the surgical outcomes of the patients, the rate of negative, non-therapeutic, and therapeutic laparotomies was 5, 11, and 84 %, respectively. No statistically significant difference between patients who did and did not receive surgery was observed with regards to blood pressure, temperature, hematocrit, hemoglobin, and C-reactive protein (CRP) values. However, a statistically significant difference was observed in the pulse rate, leukocyte, and neutrophil counts. The mortality and morbidity rates were 0.94 and 3.77 %, respectively.
  
  
  CONCLUSIONS
  Selective non-operative management, which has been standardized in trauma centers, may be carefully utilized in order to treat penetrating abdominal stab wounds with caution in well-equipped medical centers with well-trained staff.
authors.affiliation: Department of General Surgery, Umraniye Education and Research Hospital, Adem Yavuz Cad. K.Karabekir Mah., 34760, Istanbul, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Alimoglu
authors.affiliation: Department of General Surgery, Umraniye Education and Research Hospital, Adem Yavuz Cad. K.Karabekir Mah., 34760, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yucel
authors.affiliation: Department of General Surgery, Umraniye Education and Research Hospital, Adem Yavuz Cad. K.Karabekir Mah., 34760, Istanbul, Turkey.
authors.forename: I E
authors.initials: IE
authors.lastname: Subasi
authors.affiliation: Department of General Surgery, Umraniye Education and Research Hospital, Adem Yavuz Cad. K.Karabekir Mah., 34760, Istanbul, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Sisik
authors.affiliation: Department of General Surgery, Umraniye Education and Research Hospital, Adem Yavuz Cad. K.Karabekir Mah., 34760, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Basak
authors.affiliation: Department of General Surgery, Umraniye Education and Research Hospital, Adem Yavuz Cad. K.Karabekir Mah., 34760, Istanbul, Turkey. mujgan.caliskan@yahoo.com.
authors.forename: M
authors.initials: M
authors.lastname: Caliskan
keywords: Abdominal trauma; Education; Emergency surgery; Surgical critical care
references.citation: J Trauma. 1997 Oct;43(4):624-6
references.pmid: 9356058
references.citation: J Trauma. 2008 Nov;65(5):1007-11
references.pmid: 19001966
references.citation: Injury. 2008 May;39(5):530-4
references.pmid: 18336818
references.citation: Am J Surg. 1960 May;99:657-64
references.pmid: 14445378
references.citation: Swiss Med Wkly. 2010 Aug 24;140:w13058
references.pmid: 20799103
references.citation: J Trauma. 1999 Oct;47(4):622-4; discussion 624-6
references.pmid: 10528593
references.citation: J Trauma. 2010 Mar;68(3):721-33
references.pmid: 20220426
references.citation: Injury. 2012 Nov;43(11):1799-804
references.pmid: 21529801
references.citation: World J Surg. 2009 Feb;33(2):215-9
references.pmid: 19023617
references.citation: Surg Laparosc Endosc. 1998 Feb;8(1):26-9
references.pmid: 9488566
references.citation: Ann Surg. 2006 Oct;244(4):620-8
references.pmid: 16998371
references.citation: Ann Surg. 1987 Feb;205(2):129-32
references.pmid: 3813686
references.citation: J Trauma. 2005 Mar;58(3):526-32
references.pmid: 15761347
references.citation: Ann Surg. 1993 May;217(5):557-64; discussion 564-5
references.pmid: 8489319
references.citation: Am J Surg. 2008 Dec;196(6):871-7; discussion 877
references.pmid: 19095102
references.citation: Emerg Med J. 2005 Nov;22(11):790-4
references.pmid: 16244337
references.citation: J Trauma. 1995 Mar;38(3):350-6
references.pmid: 7897713