However, close analysis of these studies shows that surgeons were still wary of primary repairs for the most severe digestive wounds. Civilian surgeons started attempting primary repairs and anastomoses at the end of the 1970s this change was soon validated by dozens of articles, including five randomized controlled trials and a meta-analysis. Over the three decades following World War II, colostomy creation was the standard treatment for traumatic colon injuries. Operative management of traumatic hollow viscus injuries has been a subject of much debate, and colon injury especially remains a feared entity. Stoma creation is an important factor for postoperative morbidity, which should be weighed against the risk of an intestinal suture or anastomosis. Primary repair of bowel injuries should be the preferred option in trauma patient, regardless of the site-small bowel or colon-of the injury. Fistula rate was 2.2% all leaks occurred after repairing small bowel wounds. Risk factors for severe overall morbidity were stoma creation (p = 0.036), heavy vascular expansion (p = 0.005) and a long delay before surgery (p = 0.023). Severe overall morbidity was 32%, and abdominal complications occurred in 32% of patients. 87% of small bowel injuries and 81% of colon injuries were treated with primary repair or anastomosis, with no difference in treatment according to injury site (p = 0.381). ResultsĪmong 133 patients, 78% had small bowel injuries and 47% had colon injuries. Postoperative course was analyzed for abdominal complications, morbidity and mortality. MethodsĪll included patients underwent surgery for bowel traumatic injuries at a high volume trauma center between 20. The aim of this study was to evaluate the outcomes of such a strategy. Although anastomotic or suture leak remains a feared complication, preserving bowel continuity is increasingly the preferred strategy. Management of bowel traumatic injuries is a challenge.