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Am J Surg ; 209(3): 515-20, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25770395

RESUMO

BACKGROUND: The purpose of this study was to assess the efficacy of absorbable mesh wrapping (MW) versus perihepatic packing (HP) for severe hepatic injury. METHODS: From January 2001 to December 2012, data were collected for MW patients with hepatic injury. Patients who underwent HP were matched with MW patients by injury mechanism, liver injury grade, Injury Severity Score, and age. RESULTS: Twenty-six MW and twenty-six HP patients were matched. Eighteen blunt and 8 penetrating injuries were present in each group. There were 9 (35%) mortalities in the MW group and 16 (62%) in the HP groups (P = .03). Average transfusions were 12.0 and 24.5 (P = .03) packed red blood cells in the MW and HP groups, respectively. Average laparotomies per survivors were 1.3 for the MW and 3.1 for the HP groups (P = .01). Average length of stay for survivors was 19 and 47 (P = .04) days in the MW and HP groups, respectively. CONCLUSION: MW for hepatic injuries can significantly decrease mortality, transfusions, laparotomies, and length of stay.


Assuntos
Traumatismos Abdominais/cirurgia , Competência Clínica , Laparotomia/métodos , Fígado/lesões , Telas Cirúrgicas , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/cirurgia , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/mortalidade , Implantes Absorvíveis , Adolescente , Adulto , Desenho de Equipamento , Feminino , Seguimentos , Humanos , Fígado/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Centros de Traumatologia , Índices de Gravidade do Trauma , Resultado do Tratamento , Estados Unidos/epidemiologia , Ferimentos não Penetrantes/diagnóstico , Ferimentos não Penetrantes/mortalidade , Ferimentos Penetrantes/diagnóstico , Ferimentos Penetrantes/mortalidade , Adulto Jovem
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