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Treatment of rectal war wounds
  1. Oscar J F van Waes1,
  2. J A Halm1,
  3. J Vermeulen1 and
  4. V C McAlister2,3
  1. 1Department of Trauma Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
  2. 2Department of Surgery, The University of Western Ontario and Canadian Forces Medical Service, London, Ontario, Canada
  3. 3C4-211 University Hospital, London, Ontario, Canada
  1. Correspondence to Lt Col O J F van Waes, Department of Trauma Surgery, Erasmus MC, University Medical Centre Rotterdam, Room H-822, PO Box 2040, Rotterdam 3000 CA; The Netherlands; ovanwaes{at}gmail.com

Abstract

Treatment strategies for penetrating rectal injuries (PRI) in civilian settings are still not uniformly agreed, in part since high-energy transfer PRI, such as is frequently seen in military settings, are not taken into account. Here, we describe three cases of PRI, treated in a deployed combat environment, and outline the management strategies successfully employed. We also discuss the literature regarding PRI management. Where there is a major soft tissue component, repetitive debridement and vacuum therapy is useful. A loop or end colostomy should be used, depending on the degree of damage to the anal sphincter complex.

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