Adapting to the changing paradigm of management of colon injuries

Woo, Karen; Wilson, Matthew T.; Killeen, Kelly; Margulies, Daniel R.

doi:10.1016/j.amjsurg.2007.08.011

« Previous Next »The American Journal of Surgery
Volume 194, Issue 6 , Pages 746-750, December 2007

Adapting to the changing paradigm of management of colon injuries

Presented at the 59th Annual Meeting of the Southwestern Surgical Congress, Rancho Mirage, CA, March 25–29, 2007

Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Dr, Suite 8215, Los Angeles, CA 90048, USA

Received 31 May 2007; received in revised form 14 August 2007

Abstract

Background

Based on the evolution that the management of colonic trauma has undergone since the early 1990s, we hypothesized that the use of diversion has decreased at our institution over the last decade.

Methods

A retrospective review was performed of all patients who presented to our trauma center with colon injuries between 1995 and 2006.

Results

A total of 81 patients were analyzed. Twenty-five patients (31%) were treated with diversion and 56 patients (69%) underwent primary repair or resection with anastomosis. The rate of diversion in the first half of the study period as well as the second half of the study period was 31%. There was no difference in the complication rates.

Conclusions

The usage of diversion remains higher than current literature would indicate. As a result, we are implementing a program that will actively encourage our trauma surgeons to improve the quality of patient care by incorporating evidence-based medicine into clinical practice.

Keywords: Colon injury, Colostomy, Trauma, Primary repair