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Trauma Laparotomy

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Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes.
Clarke JR, Trooskin SZ, Doshi PJ, Greenwald L, Mode CJ.
J Trauma. 2002 Mar;52(3):420-5.

Rationale for inclusion: 243 hypotensive patients with isolated abdominal injuries were studied to find the probability of death increased 1% for every 3 minutes in the ED prior to OR.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Selective nonoperative management in 1,856 patients with abdominal gunshot wounds: should routine laparotomy still be the standard of care?
Velmahos GC, Demetriades D, Toutouzas KG, Sarkisyan G, Chan LS, Ishak R, Alo K, Vassiliu P, Murray JA, Salim A, Asensio J, Belzberg H, Katkhouda N, Berne TV.
Ann Surg. 2001 Sep;234(3):395-402; discussion 402-3.

Rationale for inclusion: Large retrospective series indicating that selective nonoperative management was a safe method of managing abdominal gunshot wounds.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Role of ultrasonography in penetrating abdominal trauma: a prospective clinical study.
Udobi KF, Rodriguez A, Chiu WC, Scalea TM.
J Trauma. 2001 Mar;50(3):475-9.

Rationale for inclusion: 75 penetrating trauma victims underwent FAST examination, revealing a sensitivity of 46% and specificity of 94%.

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Diagnostic and therapeutic laparoscopy for penetrating abdominal trauma: a multicenter experience.
Zantut LF, Ivatury RR, Smith RS, Kawahara NT, Porter JM, Fry WR, Poggetti R, Birolini D, Organ CH Jr.
J Trauma. 1997 May;42(5):825-9; discussion 829-31.

Rationale for inclusion: Large, multi-center study in which laparoscopy prevented potential unnecessary laparotomy in 54% of patients.

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Unnecessary laparotomies for trauma: a prospective study of morbidity.
Renz BM, Feliciano DV.
J Trauma. 1995 Mar;38(3):350-6.

Rationale for inclusion: A 41% complication rate was found prospectively after 254 unnecessary laparotomies.

CAVEAT: Study definition for complications included potentially benign conditions such as atelectasis or hypertension.

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Prospective comparison of diagnostic peritoneal lavage, computed tomographic scanning, and ultrasonography for the diagnosis of blunt abdominal trauma.
Liu M, Lee CH, P'eng FK.
J Trauma. 1993 Aug;35(2):267-70.

Rationale for inclusion: A prospective comparison of 55 patients who each underwent CT, ultrasound and DPL as compared with laparotomy each demonstrated good accuracy (>92%).

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Prospective evaluation of surgeons' use of ultrasound in the evaluation of trauma patients.
Rozycki GS, Ochsner MG, Jaffin JH, Champion HR.
J Trauma. 1993 Apr;34(4):516-26; discussion 526-7.

Rationale for inclusion: The trauma team of attendings, fellows and resident demonstrating a sensitivity of 79% with FAST examination.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Duration of antibiotic therapy for penetrating abdominal trauma: a prospective trial.
Fabian TC, Croce MA, Payne LW, Minard G, Pritchard FE, Kudsk KA.
Surgery. 1992 Oct;112(4):788-94; discussion 794-5.

Rationale for inclusion: Prospective, double blinded study comparing 1 versus 5 days of antibiotics for penetrating abdominal injuries.  

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

The role of laparoscopy in abdominal trauma.
Livingston DH, Tortella BJ, Blackwood J, Machiedo GW, Rush BF Jr.
J Trauma. 1992 Sep;33(3):471-5.

Rationale for inclusion: 39 patients prospectively underwent laparoscopy followed by laparotomy and demonstrated a significant rate of missed hollow viscous and splenic injuries with laparoscopy alone.

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Blunt abdominal trauma in cases of multiple trauma evaluated by ultrasonography: a prospective analysis of 291 patients.
Hoffmann R, Nerlich M, Muggia-Sullam M, Pohlemann T, Wippermann B, Regel G, Tscherne H.
J Trauma. 1992 Apr;32(4):452-8.

Rationale for inclusion: An early description regarding the use of ultrasound to determine need for laparotomy, demonstrating positive and negative predictive values of 94 and 95% respectively.

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Benefits of immediate jejunostomy feeding after major abdominal trauma--a prospective, randomized study.
Moore EE, Jones TN.
J Trauma. 1986 Oct;26(10):874-81.

Rationale for inclusion: Patients undergoing trauma laparotomy were prospectively randomized to NPO for 5 days or early jejunal feeding.  Patients who underwent early jejunal feeding were less likely to develop septic complications.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

Diagnostic Peritoneal Lavage.
Root HD, Hauser CW, McKinley CR, Lafave JW, Mendiola RP Jr.
Surgery. 1965 May;57:633-7.

Rationale for inclusion: The first description of flushing sterile fluid into the abdomen to obtain peritoneal samples in trauma.

Citations  - To review the number of citations for this landmark paper, visit Google Scholar.

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