Determinants of outcome of primary repair of colonic trauma

Abstract

OBJECTIVES:  To search of parameters for the selection of the group cases of colonic injuries getting maximum benefit of primary repair. STUDY DESIGN:  A prospective non-randomized study. SETTING:  Surgical Unit IV, DHQ Hospital, Faisalabad. SUBJECTS:  Patients with colonic trauma due to penetrating and non-penetrating injuries. MAIN OUTCOME DETERMINANTS: The main outcome determinants found significant were age, proper prompt treatment, severity of injury, haemodynamic status at the time of operation and gross faecal contamination. RESULTS: Thirty patients colonic trauma who the basis of history, clinical examination and investigations. Patients were closely observed for sign and symptoms of anastomotic leak, and intra- record of these patients was maintained on preformed proforma. All risk factors were made measurable on abdominal sepsis, wound infection. Out of 30 patients, presented to Emergency Ward during one year, underwent  exploratory   laparotomy.   The   complete 24 patients were managed by primary repair and six patients were managed by staged procedure. All the 24 patients developed no infective complications. One out of six patients of staged procedure group died on 3^rd post-operative day due to sudden myocardial infarction and three out of six patients developed infective complications. CONCLUSIONS: Age, proper prompt treatment, severity of injury, haemodynamic status at the time of operation and gross faecal contamination are determinants of outcome of primary repair of colonic trauma.