Mandatory Exploration for Penetrating Abdominal Wounds

To the Editor.—In introducing their excellent review on exploratory celiotomy for patients with truncal stab wounds, Sirinek and associates¹ note, "Introduction of the principle of mandatory exploration for all penetrating abdominal wounds during World War II resulted in markedly improved morbidity and mortality rates." Although it may be a matter of diction, I believe we should date the introduction of the principle of mandatory exploration of penetrating abdominal war wounds to World War I when the British surgeon Cuthbert Wallace proclaimed, "No man shot in the belly would be left to lie in a hospital bed in a civilian hospital.... Abdominal surgery, to be successful, must be done at once."²

Under Wallace's leadership, British surgeons near the front were operating on abdominal wounds with success by the summer of 1915. For 3520 abdominal operations performed from July 15 to September 19, 1917, the operative mortality was 53%,