Factors Affecting Morbidity Following Hepatic Trauma A Prospective Analysis of 482 Injuries
- 1 June 1991
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 213 (6), 540-548
- https://doi.org/10.1097/00000658-199106000-00003
Abstract
During a 5-year period, 482 patients with liver injuries were studied prospectively: 65% resulted from penetrating and 35% from blunt injuries. The injuries were graded by the hepatic injury scale (grades I to VI); transfusion requirements and perihepatic abscesses correlated with increasing scores. Minor surgical techniques were needed in 338 patients and 144 patients required major techniques. Omental packing was used in 60% of the major injuries and yielded 7% mortality and 8% abscess rates. Gauze packs were used for management of 10% of major injuries and yielded 29% mortality and 30% abscess rates. The patients were randomized to no drain, closed suction, or sump drainage and respective perihepatic abscess rates were 6.7%, 3.5%, and 13% (p less than 0.03; suction compared to closed suction). Multivariate analysis demonstrated increasing abdominal trauma indices and transfusion requirements as well as sump drainage to be associated independently with perihepatic infection.Keywords
This publication has 34 references indexed in Scilit:
- Patterns of Organ Injury in Blunt Hepatic Trauma and Their Significance for Management and OutcomeJournal Of Trauma-Injury Infection and Critical Care, 1989
- Septic Complications associated with the Use of Peritoneal Drains in Liver TraumaJournal Of Trauma-Injury Infection and Critical Care, 1988
- Intraabdominal sepsis after hepatic traumaThe American Journal of Surgery, 1988
- Blunt Liver Trauma at Sunnybrook Medical CentreJournal Of Trauma-Injury Infection and Critical Care, 1987
- Liver Packing for Uncontrolled Hemorrhage: A ReappraisalJournal Of Trauma-Injury Infection and Critical Care, 1986
- Cellular and humoral bases of hemorrhage-induced [depression of lymphocyte functionCritical Care Medicine, 1986
- The Value of Hepatobiliary Scanning in Complex Liver TraumaJournal Of Trauma-Injury Infection and Critical Care, 1985
- Severe liver trauma in the face of coagulopathy: A case for temporary packing and early reexplorationThe American Journal of Surgery, 1982
- Atrial-caval Shunting (ACS) after TraumaJournal Of Trauma-Injury Infection and Critical Care, 1982
- LOBAR DEARTERIALIZATION FOR EXSANGUINATING WOUNDS OF THE LIVERJournal Of Trauma-Injury Infection and Critical Care, 1972