ABSTRACT
Injuries to the small intestine and colon are found in less than 5% of victims of blunt abdominal trauma but are the most common injuries sustained after penetrating abdominal trauma. There is no consensus on the issue of stapled versus hand-sewn anastomosis after small bowel or colon resection for trauma. The hand-sewn anastomosis may be preferable in situations where the portion of the intestine under consideration for anastomosis is edematous or is at risk of becoming edematous, such as in a patient requiring a large-volume resuscitation. Injury to the small intestine has not been shown to result in a high rate of infectious complications, and skin closure after small bowel trauma is generally recommended. The debate of antibiotic duration following trauma laparotomy in general and colon injury in particular continues. Despite the lack of truly definitive trials, it is advisable to limit antibiotic prophylaxis to no more than 24 hours after laparotomy for intestinal injury.
