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Techniques of splenic preservation using fibrin glue
H B Kram1, T del Junco, S R Clark
1Department of Surgery King/Drew Medical Center, Los Angeles, California 90059.
The Journal of Trauma
|January 1, 1990
Summary
Fibrin glue (FG) effectively controlled bleeding in 16 splenic injuries, achieving an 86% splenic salvage rate. This trauma surgery adjunct shows promise for improving outcomes in spleen injury management.
Area of Science:
- Trauma Surgery
- Surgical Hemostasis
- Emergency Medicine
Background:
- Splenic injuries pose significant management challenges, with traditional methods sometimes leading to splenectomy.
- Achieving effective hemostasis in splenic trauma is critical for organ preservation and patient outcomes.
Purpose of the Study:
- To evaluate the efficacy of fibrin glue (FG) in achieving hemostasis for various splenic injuries.
- To determine the splenic salvage rate when using FG as an adjunct in trauma surgery.
Main Methods:
- Fibrin glue (FG) was applied to 16 splenic injuries in 14 patients with diverse etiologies (gunshot, stab, iatrogenic, blunt trauma).
- Intraoperative blood loss, FG volume used, and perioperative transfusion requirements were recorded.
- Postoperative outcomes, including rebleeding and abscess formation (assessed via CT scans), were monitored.
Main Results:
- An overall splenic salvage rate of 86% was achieved.
- FG effectively controlled bleeding in both superficial and deep splenic injuries, with an average of 11 ml used.
- Only one patient with a Grade V hilar vascular injury required splenectomy despite FG application.
Conclusions:
- Fibrin glue (FG) is an effective hemostatic agent for splenic injuries, including complex cases.
- The use of FG as an adjunct in trauma surgery can potentially increase splenic salvage rates.
- FG offers a viable option for managing splenic trauma, reducing the need for splenectomy.