Abstract
Impalement injury is an unique open injury which can be characterized by a penetrating, contused wound combining two distinct factors of stab wound and blunt trauma. Therefore, for its complexity appropriate managements are necessary in the treatment of this injury. From the review of nine impaled patients treated in our institute over the past seven years, the diagnosis and treatment especially perioperative management were evaluated. It was characteristic that all patients were hemodynamically stable without any episodes of hemorrhagic shock. In addition, enhanced CT scan was considered of great help obtaining an accurate route of impalement preoperatively. The patients of this type of injury may be well treated according to the following principles of perioperative managements; 1) the involved organs and the relationship to the great vessels should be assessed preoperatively; 2) the impaled object should be extricated under appropriate vascular control and direct vision; 3) the injured sites or organs should be appropriately managed; and 4) the route of impalement should be exposed as entirely as possible and debridement, hemostasis and drainage of the route should be completed.
