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Chirurgia 2005 June;18(3):107-10


language: Italian

Stab wounds: personal experience

Basile G., Nicolosi A., Primus A., Chiarenza S., Di Mari P., Buffone A.


Aim. Evaluating critically the experience reached in an Emergency Department on stab wounds, with the purpose of improve the diagnostic and therapeutic approach and, subsequently, to suggest guide-lines to treat such patients.
Methods. Forty-four patients with stab wounds observed at the Emergency Aid of Vittorio Emanuele II Hospital in Catania were studied. The average of age was 33.9; extracommunity citizens were 11 (25%). Superficial lesions were 29 (66%), deep lesions 15 (34%). First were treated by toilette and sutures. Deep lesions involved chest in 1 case, abdomen in 10 cases and chest plus abdomen in 4 cases. The injured organs were: stomach, ileus, cecum, right colic flexure, descending colon, sigmoid, liver, spleen, heart, pleura, left lung, right lung (2 cases), diaphragm (2 cases) and omentum (4 cases). In the majority of cases the operation consisted in hemostasis and suture of organ lesion; in a few cases a resection was necessary (splenectomy, right hemicolectomy, ileal resection).
Results. Among 44 patients, only 1 died (2,2%) for a cardiac lesion with hypovolemic shock. All other patients recovered without any significant complication.
Conclusion. The analysis of the data regarding the 44 patients with stab wounds has allowed to identify effective guide-lines. After a rapid exam of general and local (extension and depth of the wound) conditions, one of the following diagnostic-therapeutic approach is followed: if the patient is hemodinamically unstable, presents an evisceration or has evident signs of a peritonitis resuscitative maneuvers are carried out and subsequently the patient is transferred in the operating room for the surgical treatment; if, on the other hand, the patient is hemodinamically stable, the wound is scrupulously examined and some diagnostics exams are performed (chest X-ray, plain X-ray of the abdomen, CT, laparoscopy) in order to decide between simple suture of superficial tissues and surgical treatment in narcosis.

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