Penetran rektal yaralanmalarda morbiditeye etkili faktörler: Sivil deneyim

AMAÇ
Rektal yaralanmalarýn tedavi prensipleri savaþ deneyimlerine dayanmaktadýr. Sivil yaralanmalarda bu prensipleri uygularken sivil rektal yaralanmalarýn özelliklerini ve bunun yanýnda morbiditeye etkili faktörleri bilmek gerekir.
GEREÇ VE YÖNTEM
Ateþli silah ve delici-kesici aletle rektal yaralanma oluþmuþ 29 hastanýn özellikleri deðerlendirildi. Risk faktörlerini belirlemek amacýyla hastalar morbidite olanlar ve olmayanlar þeklinde iki gruba ayrýldý (morbidite olan: Grup 1, morbidite olmayan: Grup 2) ve faktörler gruplar arasýnda karþýlaþtýrýldý.
BULGULAR
Þiddetli fekal kontaminasyon, perianal veya gluteal yaralanma, travma tedavi intervali ve izole ekstraperitoneal yaralanma olmasý morbidite geliþimi üzerine etkili faktörlerdi. Hastanede kalýþ süresi Grup 1’de Grup 2 ile karþýlaþtýrýldýðýnda anlamlý derecede daha uzundu.
SONUÇ
Rektal yaralanmalarla nadiren karþýlaþýlmasýna raðmen, morbidite ve mortalite oranlarý yüksektir. Risk faktörlerinin bilinmesi ve hastaya göre tedavi planý yapýlmasý tedavinin baþarýsý için önemlidir. Zamanýnda tedavi edilen hastalarda morbidite oraný önemli ölçüde azalmaktadýr. Bu nedenle, doktorlarýn yaný sýra hastalarýn da rektal yaralanma konusunda bilinçli olmasý gerekmektedir.

Factors affecting morbidity in penetrating rectal injuries: a civilian experience

BACKGROUND
The principles of the treatment of rectal injuries have been determined based on the experiences gained from military injuries. While adopting these principles in civilian life, it is essential to know the characteristics of civilian rectal injuries as well as the risk factors affecting morbidity.
METHODS
The characteristics of 29 inpatients who had been treated due to rectal injuries caused by gunshot wounds and penetrating devices were evaluated. In order to determine the risk factors, the patients were divided into two groups regarding the presence of morbidity (Group 1, with morbidity; Group 2, without morbidity) and compared.
RESULTS
Severe fecal contamination, perianal or gluteal injuries, duration of trauma- treatment interval, and isolated extraperitoneal injury were significant factors that affected the development of morbidity. The length of hospital stay was significantly longer in Group 1 as compared to Group 2.
CONCLUSION
Although rectal injuries are rarely encountered, they carry high morbidity and mortality. Awareness of the risk factors and planning of a patient-based treatment are essential for the success of the therapy. The rate of morbidity is substantially decreased when patients are treated in time. Thus, the awareness of both patients as well as physicians managing trauma about rectal injuries should be increased.