Intrahepatic absorbable fine mesh packing of hepatic injuries

Preliminary clinical report

Scott B. Frame, Blaine Enderson, Ulf Schmidt, Kimball I. Maull

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

A previous report from the authors' institution reported the effectiveness of hepatic packing with absorbable fine mesh (AFMP) for the control of hemorrhage in an animal model with an otherwise lethal hepatic injury. The technique has subsequently been applied to 12 abdominal trauma patients with hemodynamic instability and actively hemorrhaging hepatic injuries. Two patients expired in the operating room owing to uncontrolled hemorrhage from hepatic and associated injuries for a mortality of 16.7%. AFMP was successful in controlling hemorrhage in the remaining 10 patients. Hepatic injuries ranged from grade II to grade V, and all were actively hemorrhaging at the time of exploration. None of the surviving 10 patients experienced early or late recurrent bleeding attributable to the hepatic injuries, and there were no intraabdominal abscesses or late deaths. Liver function studies returned to normal prior to discharge in all surviving patients. Follow-up included serial computed tomographic scans, which demonstrated fibrosis incorporating the mesh packing. Complete resolution of injury and mesh appears to proceed over approximately a 6-month period. AFMP is a safe, effective method for controlling hepatic hemorrhage. It is easy to perform in the operating room, offers an excellent matrix for hemostasis, provides tamponade of bleeding sites, and does not require reoperation for removal of packing material, as is necessary with conventional, nonabsorbable packing techniques.

Original languageEnglish (US)
Pages (from-to)575-579
Number of pages5
JournalWorld Journal of Surgery
Volume19
Issue number4
DOIs
StatePublished - Jul 1 1995

Fingerprint

Liver
Wounds and Injuries
Hemorrhage
Operating Rooms
Hemostasis
Reoperation
Abscess
Fibrosis
Animal Models
Hemodynamics
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Intrahepatic absorbable fine mesh packing of hepatic injuries : Preliminary clinical report. / Frame, Scott B.; Enderson, Blaine; Schmidt, Ulf; Maull, Kimball I.

In: World Journal of Surgery, Vol. 19, No. 4, 01.07.1995, p. 575-579.

Research output: Contribution to journalArticle

Frame, Scott B. ; Enderson, Blaine ; Schmidt, Ulf ; Maull, Kimball I. / Intrahepatic absorbable fine mesh packing of hepatic injuries : Preliminary clinical report. In: World Journal of Surgery. 1995 ; Vol. 19, No. 4. pp. 575-579.
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