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Splenic function after splenic rupture treated with an absorbable mesh

P Vanderschot1, P H Cuypers, P Rommens

  • 1Department of Traumatology and Emergency Surgery, Katholieke Universiteit Leuven, Belgium.

Der Unfallchirurg
|May 1, 1993
PubMed
Summary
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Splenic injuries can be safely treated using vicryl mesh, preserving spleen function. This method avoids splenectomy for most injuries, reducing sepsis risk after trauma.

Area of Science:

  • Trauma Surgery
  • Surgical Innovation
  • Spleen Preservation

Background:

  • Overwhelming postsplenectomy sepsis poses a significant mortality risk.
  • Spleen removal increases sepsis risk by approximately 50-fold.
  • Infection-related morbidity and mortality correlate with injury severity.

Purpose of the Study:

  • To evaluate the efficacy of vicryl mesh in treating splenic injuries.
  • To assess spleen function preservation after mesh repair.
  • To determine contraindications for mesh repair of splenic trauma.

Main Methods:

  • Retrospective analysis of 24 patients with splenic injuries treated with vicryl mesh (1987-1991).
  • Classification of splenic injuries using the Barrett system.
  • Post-treatment spleen function evaluation using 99mTc-denaturated erythrocyte scintigraphy and tomography in 20 patients.

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Main Results:

  • Vicryl mesh repair was performed on 24 patients; 3 died from unrelated craniocerebral trauma.
  • One patient required splenectomy due to rebleeding.
  • Scintigraphy showed abnormalities primarily in Type III injuries, less in Type II and I.
  • Type IV injuries were identified as a contraindication for mesh repair.

Conclusions:

  • Ruptured spleens, except for Type IV injuries, can be safely treated with vicryl mesh.
  • Vicryl mesh repair allows for spleen function preservation.
  • Splenectomy and autotransplantation are indicated for Type IV splenic injuries.