Splenorrhaphy for splenic damage in patients with multiple injuries. 1995

A P Aidonopoulos, and S T Papavramidis, and G D Goutzamanis, and G G Filos, and N P Deligiannidis, and I M Vogiatzis
Surgical Department III, A.H.E.P.A Hospital, Aristotelian University of Thessaloniki, Macedonia, Greece.

OBJECTIVE To evaluate the results of splenorrhaphy by a 'figure of eight' suture in patients with multiple injuries. METHODS Open clinical study. METHODS University hospital, Greece. METHODS 25 patients with multiple injuries after blunt abdominal trauma, 11 of whom were children. There were 2 grade II, 20 grade III, and 3 grade IV injuries. METHODS Diagnostic peritoneal lavage resulted in blood-stained effluent in all cases. A 'figure of eight' suture technique with size 0 chromic catgut mounted on a hepatic needle was used. A thin layer of sterile oxidised cellulose (Surgical) was placed over the laceration and round each knot. METHODS Mortality, morbidity, incidence of reoperation, measurements of splenic function, and adequacy of repair as judged by scintigraphy, ultrasonography, and computed tomography. RESULTS There were no deaths as a result of splenic injury. Haemorrhage from the spleen was controlled in 23 patients. The remaining two, both of whom had grade IV injuries, required ligation of the vessels of the lower pole and hemisplenectomy combined with suture. Two patients with grade III injuries bled subsequently and required splenectomy. Splenic function was good in all patients. Examination by imaging techniques showed intact and functioning splenic parenchyma. CONCLUSIONS The 'figure of eight' suture technique is a safe and reasonably successful way of controlling bleeding from a damaged spleen in a patient with multiple injuries.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009104 Multiple Trauma Multiple physical insults or injuries occurring simultaneously. Injuries, Multiple,Trauma, Multiple,Wounds, Multiple,Multiple Injuries,Polytrauma,Injury, Multiple,Multiple Injury,Multiple Traumas,Multiple Wound,Multiple Wounds,Polytraumas,Traumas, Multiple,Wound, Multiple
D010533 Peritoneal Lavage Washing out of the peritoneal cavity. The procedure is a diagnostic as well as a therapeutic technique following abdominal trauma or inflammation. Irrigation, Peritoneal,Lavage, Peritoneal,Peritoneal Irrigation
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012086 Reoperation A repeat operation for the same condition in the same patient due to disease progression or recurrence, or as followup to failed previous surgery. Revision, Joint,Revision, Surgical,Surgery, Repeat,Surgical Revision,Repeat Surgery,Revision Surgery,Joint Revision,Revision Surgeries,Surgery, Revision
D002398 Catgut Sterile collagen strands obtained from healthy mammals. They are used as absorbable surgical ligatures and are frequently impregnated with chromium or silver for increased strength. They tend to cause tissue reaction. Catguts
D002483 Cellulose, Oxidized A cellulose of varied carboxyl content retaining the fibrous structure. It is commonly used as a local hemostatic and as a matrix for normal blood coagulation. Absorbable Cellulose,Carboxycellulose,Cellulosic Acid,Oxycel,Oxycellulose,Cellulose, Absorbable,Oxidized Cellulose
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children

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