A critical review of management of 392 colonic and rectal injuries

Abstract

Summary Three hundred ninety-two patients underwent surgical treatment for injuries of the large intestine and rectum. The types of surgical intervention employed in these patients varied with severity of the trauma and location of injury. The highest incidence of wound infections and intra-abdominal abscesses occurred in the primary-repair group. Decompression technic significantly reduced the length of hospitalization, as seen in those patients with rectal injuries. This investigation does not support the contention that transfer patients are subject to a significant delay before surgery. An important surgical teaching principle is re-emphasized, namely, that trauma surgery involves a contaminated field and unnecessary surgery, such as incidental appendectomies, should be prohibited. The extent of contamination of tissue destruction, and not location of injury to the large bowel, predisposes the patient to increased morbidity.