Thoracoabdominal shotgun wounds: an evaluation of factors associated with the need for surgical intervention

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• 作者：Matthew M. Carrick ; C. Anne Morrison ; D. Jacob Alexis ; Mark A. Feanny ; Hoang Q. Pham ; Francis J. Welsh ; Michael A. Norman ; Bradford G. Scott
• 关键词：Trauma ; Shotgun ; Wounds ; Laparotomy ; Thoracotomy
• 刊名：The American Journal of Surgery
• 出版年：2009
• 出版时间：July 2009
• 年：2009
• 卷：198
• 期：1
• 页码：64-69
• 全文大小：410 K

文摘

Background

Shotgun wound classification systems attempt to predict the need for surgical intervention based on the size of wounds, pellet spread, or distance from the weapon rather than clinical findings.

Methods

A 5-year retrospective review of patients sustaining a thoracoabdominal shotgun wound was performed. Factors believed to be associated with the need for surgical intervention were examined using the Fisher exact test or an independent sample t test.

Results

Sixty-four patients suffered a thoracoabdominal shotgun wound. Fifty-nine percent required surgical intervention. Factors significantly associated with the need for surgical intervention were a low revised trauma score and systolic and diastolic blood pressure (P < .05). Distance from attacker, wound patterns, pellet size, and pellet spread were not found to have an association.

Conclusions

Clinical indicators of hemorrhage and shock are associated with the need for surgical intervention, whereas pellet spread, pellet size, and distance from the attacker are not. This is a significant departure from traditional classification systems.