An 18-year-old male suffers a gunshot wound to the abdomen, resulting in multiple injuries to the small bowel and colon. Which of the following statement(s) is/are true concerning this patient’s perioperative management?

d. The incidence of postoperative wound or intraabdominal infection would be increased in association with a colon injury

 Post-traumatic intraabdominal infection is almost always the result of gastrointestinal tract contamination. Penetrating trauma accounts for the largest proportion of these infections. Because of the higher bacterial counts, the colon is consistently associated with a higher incidence of infectious complications than isolated gastric, duodenal, or small bowel injuries. The precise incidence of intraabdominal or incisional wound infection after colonic injuries depends on factors present at the time of injury (blood loss, degree of contamination, and other associated injuries) and on whether the wound is closed or left open. The use of perioperative antibiotics for trauma has been investigated extensively. Most studies have demonstrated that single-agent cephalosporins are at least as effective as multi-agent regimens in retarding intraabdominal abscess or wound infections resulting from a variety of contaminated traumatic wounds. Fever, leukocytosis, tachycardia, the development of a paralytic ileus, increased fluid requirements, and failure to wean from a mechanical ventilation may all represent warning signs of the development of intraabdominal infection. CT is the single most useful diagnostic tool in this clinical setting because it yields considerable information with regard to organ injury in the presence of intraabdominal abscesses or fluid collections. Laparotomy, as a diagnostic tool for unexplained sepsis, has a low-yield in critically ill trauma patients and should not be used routinely.