Evolution of the operative management of colon trauma

John P. Sharpe, Louis J. Magnotti, Timothy C. Fabian, Martin Croce

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

For any trauma surgeon, colon wounds remain a relatively common, yet sometimes challenging, clinical problem. Evolution in operative technique and improvements in antimicrobial therapy during the past two centuries have brought remarkable improvements in both morbidity and mortality after injury to the colon. Much of the early progress in management and patient survival after colon trauma evolved from wartime experience. Multiple evidence-based studies during the last several decades have allowed for more aggressive management, with most wounds undergoing primary repair or resection and anastomosis with an acceptably low suture line failure rate. Despite the abundance of quality evidence regarding management of colon trauma obtained from both military and civilian experience, there remains some debate among institutions regarding management of specific injuries. This is especially true with respect to destructive wounds, injuries to the left colon, blunt colon trauma and those wounds requiring colonic discontinuity during an abbreviated laparotomy. Some programs have developed data-driven protocols that have simplified management of destructive colon wounds, clearly identifying those high-risk patients who should undergo diversion, regardless of mechanism or anatomic location. This update will describe the progression in the approach to colon injuries through history while providing a current review of the literature regarding management of the more controversial wounds.

Original languageEnglish (US)
Article numbere000092
JournalTrauma Surgery and Acute Care Open
Volume2
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Colon
Wounds and Injuries
Laparotomy
Sutures
History
Morbidity
Survival
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Evolution of the operative management of colon trauma. / Sharpe, John P.; Magnotti, Louis J.; Fabian, Timothy C.; Croce, Martin.

In: Trauma Surgery and Acute Care Open, Vol. 2, No. 1, e000092, 01.01.2017.

Research output: Contribution to journalArticle

Sharpe, John P. ; Magnotti, Louis J. ; Fabian, Timothy C. ; Croce, Martin. / Evolution of the operative management of colon trauma. In: Trauma Surgery and Acute Care Open. 2017 ; Vol. 2, No. 1.
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