Faculty and Staff Publications
Publication Date
1-1-2023
Journal
Trauma Surgery & Acute Care Open
Abstract
OBJECTIVES: The risk factors for anastomotic leak (AL) after resection and primary anastomosis for traumatic bucket handle injury (BHI) have not been previously defined. This multicenter study was conducted to address this knowledge gap.
METHODS: This is a multicenter retrospective study on small intestine and colonic BHIs from blunt trauma between 2010 and 2021. Baseline patient characteristics, risk factors, presence of shock and transfusion, operative details, and clinical outcomes were compared using R.
RESULTS: Data on 395 subjects were submitted by 12 trauma centers, of whom 33 (8.1%) patients developed AL. Baseline details were similar, except for a higher proportion of patients in the AL group who had medical comorbidities such as diabetes, hypertension, and obesity (60.6% vs. 37.3%, p=0.015). AL had higher rates of surgical site infections (13.4% vs. 5.3%, p=0.004) and organ space infections (65.2% vs. 11.7%, p0.05). More patients with AL were discharged with an ostomy (69.7% vs. 7.3%, p6 units of packed red blood cells, and site of injury (adjusted RR=2.32 (1.13, 5.17)), none of which were independent risk factors in themselves.
CONCLUSION: Damage control surgery performed as the initial operation appears to double the risk of AL after intestinal BHI, even after controlling for other markers of injury severity.
LEVEL OF EVIDENCE: III.
Keywords
Small intestine, colon, Ischemia, abdominal injuries
Included in
Digestive System Diseases Commons, Medical Sciences Commons, Mental and Social Health Commons, Surgery Commons, Trauma Commons, Wounds and Injuries Commons
Comments
Supplementary Materials
PMID: 38020867