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Evaluation and management of abdominal stab wounds

A Western Trauma Association critical decisions algorithm

Martin, Matthew J., MD; Brown, Carlos V.R., MD; Shatz, David V., MD; Alam, Hasan B., MD; Brasel, Karen J., MD; Hauser, Carl J., MD; de Moya, Marc, MD; Moore, Ernest E., MD; Rowell, Susan E., MD; Vercruysse, Gary A., MD; Baron, Bonny J., MD; Inaba, Kenji, MD

Journal of Trauma and Acute Care Surgery: November 2018 - Volume 85 - Issue 5 - p 1007–1015
doi: 10.1097/TA.0000000000001930

ABSTRACT This is a recommended management algorithm from the Western Trauma Association addressing the management of adult patients with abdominal stab wounds. Because there is a paucity of published prospective randomized clinical trials that have generated Class I data, these recommendations are based primarily on published observational studies and expert opinion of Western Trauma Association members. The algorithm and accompanying comments represent a safe and sensible approach that can be followed at most trauma centers. We recognize that there will be patient, personnel, institutional, and situational factors that may warrant or require deviation from the recommended algorithm. We encourage institutions to use this as a guideline to develop their own local protocols.

From the Legacy Emanuel Medical Center (M.J.M.), Portland, Oregon; Dell Medical School (C.V.R.B.), University of Texas at Austin, Austin, Texas; University of California–Davis (D.V.S.), Sacramento, California; University of Michigan (H.A., G.V.), Ann Arbor, Michigan; Oregon Health and Science University (K.B., S.R.), Portland, Oregon; Beth Israel Deaconess Medical Center (C.H.), Boston, Massachusetts; Medical College of Wisconsin (M.D.), Milwaukee, Wisconsin; Denver Health (E.E.M.), Denver, Colorado; Kings County Hospital (B.B.), Brooklyn, New York; and University of Southern California (K.I.), Los Angeles, California.

Submitted: January 14, 2018, Revised: March 12, 2018, Accepted: March 24, 2018, Published online: April 13, 2018.

Presented at the 47th Annual Western Trauma Association Meeting, Whistler, Utah, March 5–10, 2017.

Disclaimer: The results and opinions expressed in this article are those of the authors and do not reflect the opinions or official policy of any of the listed affiliated institutions, the United States Army, or the Department of Defense.

Address for reprints: Matthew J. Martin, MD, Trauma and Emergency Surgery Service, Legacy Emanuel Medical Center, 2801 N Gantenbein Portland, OR 97227 503/413-2200; email:

© 2018 Lippincott Williams & Wilkins, Inc.