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Logo of mjafiGuide for AuthorsAbout this journalExplore this journalMedical Journal, Armed Forces India
Med J Armed Forces India. 2005 January; 61(1): 96.
Published online 2011 July 21. doi:  10.1016/S0377-1237(05)80146-7
PMCID: PMC4923340

Treatment of Casualties in a Forward Hospital of Indian Army: Nine Years Experience: Reply

KM Rai, SM

The author thanks…. for this letter, and is in broad agreement with the views expressed therein. Colonic injuries were repaired primarily only in selected cases in the present series, as is clearly mentioned in the section on ‘Abdominal Trauma’ on page 21 of the Journal. Gross contamination of peritoneum, severe hemodynamic instability and delayed surgery are obvious contraindications to this approach. The case of always performing a colostomy for high velocity gunshot wounds (GSW) is overstated; it may be very difficult to tell whether abdominal GSW is of low or high velocity. The experience of the surgeon and the facilities available in the hospital would determine the approach. The aim of mentioning primary colonic repair was to impress upon the surgeons that this can be undertaken for war injuries under favourable circumstances. The statement needs qualification (see above), and is not an across the board recommendation, certainly not for surgeons working in field ambulances and forward surgical centers.

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