@article{ref1,
title="The significance of penetrating gluteal injuries: an analysis of the operation Iraqi freedom experience",
journal="Journal of Surgical Education",
year="2008",
author="Lesperance, Kelly and Martin, M. J. and Beekley, Alec C. and Steele, Scott R.",
volume="65",
number="1",
pages="61-66",
abstract="BACKGROUND: Although penetrating gluteal injuries rarely are life-threatening, the risk for concomitant injury to regional anatomic structures warrants additional evaluation. We analyzed factors affecting the management and outcomes of these injuries. METHODS: Retrospective analysis of prospectively collected data from the 31st Combat Support Hospital during Operation Iraqi Freedom over a 16 month period. RESULTS: From 3442 patients, 115 patients (3.3%) suffered penetrating gluteal injuries. They were predominately male (98%) with a mean injury severity score of 13. Mortality was 6% (n = 7). Primary mechanisms of injury were improvised explosive devices (41%) and gunshot wounds (59%). Associated injuries were present in 57% of patients [orthopedic (35%), abdominal (29%), rectal (25%), vascular (21%), genitourinary (14%), pulmonary (11%), sphincter (9%)]. Overall, 76% required surgical management, with 14% developing postoperative complications. In total, 27 patients (24%) required stoma placement. Gunshot wounds were associated with through and through injuries (43% vs 6%, p &lt; 0.01), rectal injury (35% vs 11%, p &lt; 0.05), and stoma placement (32% vs 11%, p &lt; 0.05). Blast injuries were associated with a higher mean transfusion requirement (11 vs 6 units, p &lt; 0.05), increased length of stay (14 vs 9 days, p &lt; 0.05), and traumatic brain injury (24% vs 6%, p &lt; 0.05). Independent predictors of a need for stoma placement were gunshot wounds (odds ratio = 10, p &lt; 0.05) and injury severity score greater than 20 (odds ratio = 27, p &lt; 0.01). CONCLUSIONS: Penetrating gluteal injuries are associated with significant damage to local structures. Gunshot wounds carry a higher risk of injury to the rectum and stoma placement, whereas blast injuries are associated with less local injury and more multisystem trauma.   <p>Language: en</p>",
language="en",
issn="1931-7204",
doi="10.1016/j.jsurg.2007.08.004",
url="http://dx.doi.org/10.1016/j.jsurg.2007.08.004"
}