A decade long overview of damage control laparotomy for abdominal gunshot wounds.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-06-18 DOI:10.1007/s00068-024-02563-2

Reuben He, Victor Kong, Jonathan Ko, Anantha Narayanan, Howard Wain, John Bruce, Grant Laing, Vassil Manchev, Wanda Bekker, Damian Clarke

{"title":"A decade long overview of damage control laparotomy for abdominal gunshot wounds.","authors":"Reuben He, Victor Kong, Jonathan Ko, Anantha Narayanan, Howard Wain, John Bruce, Grant Laing, Vassil Manchev, Wanda Bekker, Damian Clarke","doi":"10.1007/s00068-024-02563-2","DOIUrl":null,"url":null,"abstract":"Purpose: Over the last three decades, damage control laparotomy (DCL) has become important in the management of abdominal gunshot wounds (GSW). This paper reviews the experience of a single institution over a decade with the use of DCL for GSW of the abdomen.Methods: Longitudinal data (2013-2022) was collected from the Hybrid Electronic Medical Registry database to identify all patients with an abdominal GSW over the study period. The data was stratified based on patients who underwent DCL and those who did not. Descriptive analysis was completed to summarise the raw data. Univariate and multivariate analysis was completed to identify variables associated with undergoing DCL.Results: There were 135 patients (32%) who underwent DCL and 290 patients (68%) who did not. Colonic, small bowel, mesenteric, hepatic, pancreatic and intra-abdominal vessel injuries were associated with the need for DCL (P<0.05). In total, 85 of the 135 (63%) patients who underwent DCL required more than one damage control technique. There were 45 (33%) mortalities in the DCL group compared to 16 mortalities (6%) in the non-DCL group (P<0.001).Conclusion: One third of patients who underwent a laparotomy following a gunshot wound to the abdomen had a DCL. The indications for DCL include both physiological criteria and injury patterns. DCL is associated with significant morbidity and mortality. Efforts need to be directed towards refining the indications for DCL in this group of patients to prevent inappropriate application of this potentially lifesaving technique.","PeriodicalId":1,"journal":{"name":"Accounts of Chemical Research","volume":null,"pages":null},"PeriodicalIF":16.4000,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Accounts of Chemical Research","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00068-024-02563-2","RegionNum":1,"RegionCategory":"化学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MULTIDISCIPLINARY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose: Over the last three decades, damage control laparotomy (DCL) has become important in the management of abdominal gunshot wounds (GSW). This paper reviews the experience of a single institution over a decade with the use of DCL for GSW of the abdomen.

Methods: Longitudinal data (2013-2022) was collected from the Hybrid Electronic Medical Registry database to identify all patients with an abdominal GSW over the study period. The data was stratified based on patients who underwent DCL and those who did not. Descriptive analysis was completed to summarise the raw data. Univariate and multivariate analysis was completed to identify variables associated with undergoing DCL.

Results: There were 135 patients (32%) who underwent DCL and 290 patients (68%) who did not. Colonic, small bowel, mesenteric, hepatic, pancreatic and intra-abdominal vessel injuries were associated with the need for DCL (P<0.05). In total, 85 of the 135 (63%) patients who underwent DCL required more than one damage control technique. There were 45 (33%) mortalities in the DCL group compared to 16 mortalities (6%) in the non-DCL group (P<0.001).

Conclusion: One third of patients who underwent a laparotomy following a gunshot wound to the abdomen had a DCL. The indications for DCL include both physiological criteria and injury patterns. DCL is associated with significant morbidity and mortality. Efforts need to be directed towards refining the indications for DCL in this group of patients to prevent inappropriate application of this potentially lifesaving technique.

查看原文本刊更多论文

腹部枪伤的损伤控制开腹手术十年概述。

目的：过去三十年来，损伤控制开腹术（DCL）在腹部枪伤（GSW）的治疗中变得越来越重要。本文回顾了一家医疗机构十年来使用损伤控制开腹术治疗腹部枪伤的经验：从混合电子医疗登记数据库中收集了纵向数据（2013-2022 年），以确定研究期间所有腹部枪伤患者的身份。根据接受 DCL 和未接受 DCL 的患者对数据进行了分层。对原始数据进行了描述性分析。完成了单变量和多变量分析，以确定与接受DCL相关的变量：结果：接受 DCL 的患者有 135 人（32%），未接受 DCL 的患者有 290 人（68%）。结肠、小肠、肠系膜、肝脏、胰腺和腹腔内血管损伤与是否需要接受 DCL 相关（结论：三分之一的患者接受了 DCL：在腹部枪伤后接受开腹手术的患者中，有三分之一需要进行 DCL。DCL 的适应症包括生理标准和损伤模式。DCL 与严重的发病率和死亡率有关。需要努力完善该类患者的 DCL 适应症，以防止不适当地使用这一可能挽救生命的技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.