Traditional Treatment of Colon Injuries: An Effective Method

Several recent reports have described management of penetrating colon wounds with primary closure, exteriorization, and early return to the abdominal cavity. Since this procedure was not the technique practiced at our institution, we reviewed our five-year experience with 207 patients with such wounds to determine whether a change in methods was warranted. The patients, predominantly young and male, were often victims of gunshots or stabbings. Associated injuries (intra-abdominal, 64%; extra-abdominal, 35%) were frequent. Overall mortality was 4% and included three patients who died within 24 hours of admission. Morbidity was 43%, including 17% related to colon injury. All documented colostomy closures were without mortality. We concluded that management of penetrating colon injuries by traditional methods yields low morbidity and mortality. A comparison of our results with those obtained using alternative techniques convinced us that the continued use of traditional methods in treating colon trauma is warranted.