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Primary Repair of Colonic Injuries-Reply

Arch Surg. 1976;111(6):725. doi:10.1001/archsurg.1976.01360240104025.
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To the Editor.—The article "Experimental Evaluation of Primary Repair of Colonic Injuries" by Matolo et al (Arch Surg 111:78-80, 1976) is a valuable—and yet worrisome—contribution. The article reconfirms current knowledge that appropriate preoperative, postinjury antibiotic "loading" reduces morbidity and mortality.

The contribution is worrisome in that the authors render generic conclusions regarding posttraumatic colonic closure from an experimental model that may not be duplicative of human injury.

The authors do not state the manner in which their experimental lacerations were created. We suspect these to have been cleanly incised lesions, since that would be the simplest way to control length. Such injury is duplicative only of such penetrating abdominal trauma as a stab wound. Certainly there is no element of crush, temporary cavity effect, or ischemia in the model. Furthermore, it is not at all clear that injury of the midtransverse colon is analogous to injuries elsewhere in the colon.


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