Management of abdominal stab wounds

McNabney, W. Kendall; McCanse, Andrew

doi:10.1016/0002-9610(67)90137-7

Cited by 8 publications

(2 citation statements)

References 4 publications

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“…This observation is confirmed in the data of Wilson and Sherman 40 and in the report of McNabney and McCanse. 41 The oft-expressed fear that a delay in exploration will increase morbidity and/or mortality is not supported by these nor by any other data we can find.…”

Section: Discussionmentioning

confidence: 73%

Validating the Western Trauma Association Algorithm for Managing Patients With Anterior Abdominal Stab Wounds: A Western Trauma Association Multicenter Trial

Biffl

Kaups

Pham

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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The WTA proposed algorithm is designed for cost-effectiveness. Serial clinical assessments can be performed without the added expense of CT, DPL, or laparoscopy. Patients requiring LAP generally manifest early in their course, and there does not appear to be any morbidity related to a delay to OR. These data validate this approach and should be confirmed in a larger number of patients to more convincingly evaluate the algorithm's safety and cost-effectiveness compared with other approaches.

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Section: Discussionmentioning

confidence: 73%

Validating the Western Trauma Association Algorithm for Managing Patients With Anterior Abdominal Stab Wounds: A Western Trauma Association Multicenter Trial

Biffl

Kaups

Pham

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…McNabney and colleagues in Missouri, Mason in Chicago, and Shaftan and Richter in New York performed studies examining the same question and came to the conclusion that clinical exam would accurately predict need for laparotomy. 4,5,13 It was Nance and Cohn, however, who were the first to show conclusively that delay in operation did not, in fact, convey a higher risk of mortality, thereby making it ethically possible for surgeons to expectantly manage these patients and take the risk of being wrong.…”

Section: Discussionmentioning

confidence: 99%

The Hidden Story of Innovation: Charity Hospital, Angola Prison, and the Challenging of Surgical Dogma

Greiffenstein

Hastings

2017

The American Surgeon

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The late 1960s was a period of significant upheaval of social, cultural, and scientific norms. The generally accepted notion of mandatory laparotomy for all penetrating abdominal injuries was among those norms being called into question across the country and many advocated expectant management of selected patients presenting with this type of injury. Leaders of the surgical community published opinions on either side of the argument. The house staff at Charity Hospital during this period was among the busiest in the nation in treating these injuries, many of them inmates of the Louisiana State Penitentiary who used self-inflicted stab wounds to the abdomen as a means of temporary respite from the inhumane conditions in the prison. Inspired, in part, by the overabundance of negative laparotomies among this group, F. Carter Nance went on to systematically challenge the standard of care. This effort constitutes one of the major forces for change of the surgical dogma of mandatory laparotomy for all abdominal stab wounds. It is the first major study to show conclusively that delayed laparotomy for perforated viscous was not significantly detrimental and posed less of a risk than unnecessary laparotomy. The circumstances surrounding this initiative constitute a powerful and heretofore unknown chapter in the history of surgical innovation.

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