ABSTRACT
The current dogma about the treatment of penetrating colon injuries is reviewed, both
from the civilian and the military perspective. This discussion is still evolving,
and the time-honored methods of diversion, including colostomy and ileostomy, are
still appropriate for the most severe and devastating sorts of wounds, especially
in the military context. For the vast majority of penetrating wounds, primary repair
works well and should be practiced. For the few patients who have primary repair that
fails and leaks, mortality rates are high. The art of surgery involves knowing when
to divert and when to repair.
KEYWORDS
Penetrating colon trauma - colostomy - ileostomy - primary repair - damage control
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David R WellingM.D.
Surgery and Anatomy, Uniformed Services University
4301 Jones Bridge Rd., Bethesda, MD 20814-4799
Email: dwelling@usuhs.mil