Stab wound

Stab wound
Classification and external resources

A depiction of Jereboam O. Beauchamp stabbing Solomon P. Sharp.
ICD-10 X99
ICD-9 E966
eMedicine topic list

A stab wound is a specific form of penetrating trauma that results from a knife, or a similar pointed object that is "deeper than it is wide".[1][2][3][4] Most stabbings occur because of intentional violence or through self infliction.[5] Typically deaths caused by stabbings are due to organ failure or blood loss.

Contents

Cause

Stabbings are a relatively common cause of homicide in Canada[6] and the USA.[7] They are the mechanism of approximately 2% of suicide.[8]

Management

Stab wounds can cause various internal injuries. The abdomen is the most commonly injured area from a stab wound because in most cases stab wounds occur below the nipple and penetrate the abdomen. Interventions that may be needed are airway control and intravenous access; pressure on a bleeding wound may reduce blood loss.[5][9] The length and size of the knife blade may be important in planning management.[1][3]

Surgery

Surgical intervention may be needed.[3] It is important for care providers to thoroughly check the wound site inasmuch as a laceration of an artery in most cases results in delayed complications sometimes can can lead to death.[1] Special precautions should also be used to prevent further injury from a perpetrator to the victim in a hospital setting.[10]

Epidemiology

In Canada homicides by stabbing and gun shot occur relatively equally (1008 to 980 for the years 2005 to 2009).[6] In the United States guns are a more common method of homicide (9,484 verses 1,897 for stabbing or cutting in 2008).[7]

Stab wounds occur four times more than gunshot wounds in the United Kingdom, but the mortality rate associated with stabbing has ranged from 0-4% as 85% of injuries sustained from stab wounds only affect subcutaneous tissue.[9][10][11] Generally, attacks motivated by religious or political disagreement tend to be more violent and therefore have higher mortality rates than other attacks.[11] Most assaults resulting in a stab wound occur to men and persons of ethnic minorities.[12]

History

The first successful operation on a person who was stabbed in the heart was performed in 1896 by Ludwig Rehn, in what is now considered the first case of heart surgery.[13]

References

  1. ^ a b c Rosen, Peter; John J. Ratey MD; Marx, John A.; Robert I. Simon MD; Hockberger, Robert S.; Ron Walls MD; Walls, Ron M.; Adams, James L. (2010). Rosen's emergency medicine: concepts and clinical practice. St. Louis, Mo: Mosby/Elsevier. pp. 456–7. ISBN 0-323-05472-2. 
  2. ^ Taber, Clarence Wilbur; Venes, Donald (2009). Taber's cyclopedic medical dictionary. F a Davis Co. p. 2189. ISBN 0-8036-1559-0. 
  3. ^ a b c Mankin SL (September 1998). "Emergency! Stab wound". The American Journal of Nursing 98 (9): 49. PMID 9739749. http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0002-936X&volume=98&issue=9&spage=49. Retrieved 2011-09-30. 
  4. ^ Abdullah F, Nuernberg A, Rabinovici R (January 2003). "Self-inflicted abdominal stab wounds". Injury 34 (1): 35–9. PMID 12531375. http://linkinghub.elsevier.com/retrieve/pii/S0020138302000840. Retrieved 2011-09-30. 
  5. ^ a b Sugrue M, Balogh Z, Lynch J, Bardsley J, Sisson G, Weigelt J (August 2007). "Guidelines for the management of haemodynamically stable patients with stab wounds to the anterior abdomen". ANZ Journal of Surgery 77 (8): 614–20. doi:10.1111/j.1445-2197.2007.04173.x. PMID 17635271. http://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=1445-1433&date=2007&volume=77&issue=8&spage=614. Retrieved 2011-09-30. 
  6. ^ a b http://www40.statcan.ca/l01/cst01/legal01-eng.htm Homicides by method
  7. ^ a b http://www.infoplease.com/ipa/A0004888.html Murder Victims, by Weapons Used
  8. ^ Riviello, edited by Ralph J. (2010). Manual of forensic emergency medicine : a guide for clinicians. Sudbury, Mass.: Jones and Bartlett Publishers. pp. 18. ISBN 9780763744625. 
  9. ^ a b Campbell, John Creighton (2000). Basic trauma life support for paramedics and other advanced providers. Upper Saddle River, N.J: Brady/Prentice Hall Health. ISBN 0-13-084584-1. 
  10. ^ a b Bird J, Faulkner M (2009). "Emergency care and management of patients with stab wounds". Nurs Stand 23 (21): 51–7; quiz 58. PMID 19248451. 
  11. ^ a b Hanoch J, Feigin E, Pikarsky A, Kugel C, Rivkind A (August 1996). "Stab wounds associated with terrorist activities in Israel". JAMA 276 (5): 388–90. PMID 8683817. 
  12. ^ El-Abdellati E, Messaoudi N, Van Hee R (2011). "Assault induced stab injuries: epidemiology and actual treatment strategy". Acta Chirurgica Belgica 111 (3): 146–54. PMID 21780521. 
  13. ^ "History of Cardiac Surgery - Stephenson 3 (2008): 3 - Cardiac Surgery in the Adult". Cardiacsurgery.ctsnetbooks.org. http://cardiacsurgery.ctsnetbooks.org/cgi/content/full/3/2008/3?ck=nck. Retrieved 2011-10-10.