The use of a selective non-operative management (SNOM) policy, or treating patients without surgery, for specific cases of gunshot and stab wounds to the abdomen has proved to decrease complications and lower treatment costs.

In a study published in the British Journal of Surgery, researchers examined the cases of 12,707 patients with abdominal gunshot wounds and 13,030 patients with stab wounds between 2002-2008. Patients with additional injuries were excluded. It was found that when monitored carefully, abdominal injuries could be treated successfully without the need for surgery.

'The ability to manage patients without having to perform an operation means not only fewer potential postoperative complications, but also decreased costs and resource use,' the study explains. 'SNOM of penetrating abdominal injury (PAI) is recommended in facilities with the resources and experience to select and monitor patients with PAI carefully, along with the capability to provide immediate surgical intervention to those who need it.'

In the gunshot wound patients, 77.8% were operated on, while SNOM was used in the other 22.2%. The use of SNOM increased from 18.8% to 24% in the seven-year period with an overall decrease in the amount of times SNOM failed. Of the 740 patients who did not benefit from SNOM, only 20 died.

In abdominal stab injuries, 33.9% of patients were treated with SNOM. Its use increased from 23.6% to 37% in the seven-year period, and of the 791 patients who did not benefit from SNOM, nine died.

Click here to see the study.

Image: ICU. Credit: rafahkid on Flickr.