Japanese Journal of Acute Care Surgery
Online ISSN : 2436-102X
Advantages and disadvantages of the non-operative management (NOM) protocol for abdominal trauma
Yusuke Ito
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2020 Volume 10 Issue 1 Pages 38-43


Non-operative management (NOM) with stable hemodynamics is a standard, and highly successful treatment for abdominal trauma. However, there is no standard protocol for NOM. Our hospital created a NOM protocol in April 2011, and has implemented it ever since. We scrutinized the advantages and disadvantages of this protocol. We examined 126 cases of abdominal trauma treated with the NOM protocol from January 2013 to March 2018. Bed rest was recommended for 3 days (2-4 days) and strict nil per os for 3 days (3-4 days). The NOM completion rate was 96%. We observed pseudoaneurysms in 13.5% of the cases, and 11.1% of the cases required an additional endovascular treatment. The complications included deep vein thrombosis (3.2%) and pneumonia (7.9%). After discharge, no patients experienced delayed bleeding and there were no deaths. The protocol compliance rate was 19.8%. We modified the standard image evaluation and revised the protocol. The NOM protocol is effective and improves the quality of medical care.

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© 2020 The Japanese Society for the Acute Care Surgery
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