Abdominal Stab Wound Exploration Periprocedural Care

Updated: May 04, 2018
  • Author: Juan L Poggio, MD, MS, FACS, FASCRS; Chief Editor: Erik D Schraga, MD  more...
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Periprocedural Care

Equipment

The list of equipment is as follows:

  • Adequate light source or operating lamp

  • Sterile gloves

  • Surgical masks

  • Surgical caps

  • Protective eyewear

  • Sterile gowns

  • Sterile drapes

  • Cleaning solution (10% povidone iodine [Betadine] or other suitable solution)

  • Lidocaine hydrochloride (1%) with epinephrine

  • Gauze swabs

  • Suture material (See Technique for suggestion of suture material.)

  • Wound dressing

  • Washout irrigant (1 L of 0.9% NaCl)

  • Scalpel handle

  • Blades, 2

  • Retractors, 2

  • Dissecting forceps (toothed and untoothed)

  • Needle holder

  • Scissors (curved dissecting and stitch scissors)

  • Hemostats, 5

  • Diathermy may be used, if available. Diathermy assists with achieving hemostasis.

    Equipment required for an abdominal stab wound exp Equipment required for an abdominal stab wound exploration.
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Patient Preparation

Anesthesia

Local anesthesia is used. Use local anesthesia liberally, as patient comfort is essential. The procedure requires patient compliance and adequate anesthesia. Hemostasis is also important. The authors’ suggested preparation is 1% lidocaine hydrochloride (10 mg/mL) with epinephrine 1:200,000 (5 mcg/mL). Other preparations can be used. The maximum dose of lidocaine combined with epinephrine is 7 mg/kg, up to 500 mg.

Local exploration in uncooperative patients is best performed in the operating room under general anesthesia.

For more information, see Infiltrative Administration of Local Anesthetic Agents.

Positioning

The patient is positioned supine. Adequate exposure of the abdomen is essential. Abdominal stab wound exploration can be effectively performed in the emergency department.

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