Kevin Lapu1, M Mathew, G Gende, I Kevau. 1. Surgery Unit, Angau Memorial Hospital, PO Box 457, Lae, Morobe Province 411, Papua New Guinea.
Abstract
UNLABELLED: Trauma is a leading cause of admissions to the surgical ward in Papua New Guinea (PNG), accounting for about 35% of cases. Of these, 15% of cases are abdominal injuries, of which 19% are penetrating injuries. Selective surgical management of patients with a low-velocity anterior abdominal wound (AAW) is beneficial in some patients. AIM: To determine if selective surgical management is a viable therapeutic option in PNG. METHODS: A non-random prospective study of consecutive cases was done on 60 patients with an AAW based entirely on clinical symptoms and signs. The outcome measures were length of hospital stay, morbidity and mortality. Data were analysed using SPSS 10.0 for Windows and Microsoft Excel. RESULTS: Immediate laparotomy was done on 24 (40%) of cases and 36 (60%) had nonoperative conservative management, of which 6 (17%) failed and went on to have laparotomy on demand. The average hospital stay was 4 days shorter (p = 0.0001) for the nonoperative group, which had significantly fewer complications (p = 0.01). No deaths were recorded in either of the two groups of patients. CONCLUSION: Selective nonoperative management of stable patients with an AAW with or without omental signs is a safe therapeutic option in PNG.
UNLABELLED: Trauma is a leading cause of admissions to the surgical ward in Papua New Guinea (PNG), accounting for about 35% of cases. Of these, 15% of cases are abdominal injuries, of which 19% are penetrating injuries. Selective surgical management of patients with a low-velocity anterior abdominal wound (AAW) is beneficial in some patients. AIM: To determine if selective surgical management is a viable therapeutic option in PNG. METHODS: A non-random prospective study of consecutive cases was done on 60 patients with an AAW based entirely on clinical symptoms and signs. The outcome measures were length of hospital stay, morbidity and mortality. Data were analysed using SPSS 10.0 for Windows and Microsoft Excel. RESULTS: Immediate laparotomy was done on 24 (40%) of cases and 36 (60%) had nonoperative conservative management, of which 6 (17%) failed and went on to have laparotomy on demand. The average hospital stay was 4 days shorter (p = 0.0001) for the nonoperative group, which had significantly fewer complications (p = 0.01). No deaths were recorded in either of the two groups of patients. CONCLUSION: Selective nonoperative management of stable patients with an AAW with or without omental signs is a safe therapeutic option in PNG.
Authors: Osman Kones; Cevher Akarsu; Halil Dogan; Yildiz Okuturlar; Ahmet Cem Dural; Mehmet Karabulut; Eyup Gemici; Halil Alis Journal: Turk J Emerg Med Date: 2016-03-10