Back ground: In Iraq, after 2003 had more
accidents of the shell, bullet and stab abdominal
wounds, more over colon injuries.
Objective: The aim of this study is to evaluate
the most appropriate management of penetrating
colon injuries, comparing the primary repair with
the diversion.
Methods: Eighty patient series with shell, bullet
and stab colonic injuries during 4.5 years period
from June 2006-december 2010 at Al-Yarmouk
teaching hospital. The study compared the use of
primary repair versus diversion, analyzing
variables such as sex, age, severity of injury and
mortality rate.
Results: there were total 80 patients ,62 (77.5%)
male and 18(22.5%) female .male :female ratio
3.4:1. the most affected age group was 21-30
years. 47 patients 58.75% were shell injuries.28
patients 35% were bullet injuries. 5 patients
6.25% were stab wounds. 46 patients 57.5%
managed by primary repair ,one of them 1.25%
died, while diversion in34patients 42.5%
different grades of colon injuries ,5 of them
6.25% died ,this was due to different factors such
as multiple organ injuries and post operative
complications.
Conclusion: the primary repair is safe and
effective regarding morbidity and mortality in
the management of grade II, III penetrating colon
injuries with minimal risk factors as compared to
diversion.
This research has come out with that strategies made by Porter as generally strategies applicable to any size and type of economic units cannot be applied to many of the economic units in the world in generally and in Iraq especially not a lot of economic units have the resources and competencies that enable them to provide a unique product of its kind in the minds of customers and then adopt a differentiation strategy and not a lot of economic units have the resources and competencies that make them the cost leader. Differentiators and cost leaders are minority in the world while not differentiators and not cost leaders are majority in the world.
The economic units are not differentiators and not c
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