SEARCH

Algorithms main page

Adult Blunt Splenic Trauma algorithm

Adult Blunt Splenic Trauma Notes:
Introduction
Historic Perspective
Table 1
Note A Table 2 Note B Note C Note D Note E Note F Table 3 Note G Note H Note I Note J Note K References

  

 
Western Trauma Association
Management of Adult Blunt Splenic Trauma

 

Annotation for Point K

 
The decision of whether to perform a splenectomy is dependent on the patient's condition and associated injuries. Unfortunately, most patients go to the OR because of hemodynamically instability and splenectomy is the most prudent option. Splenic salvage should be pursued in the hemodynamically stable patient. Techniques include topical hemostatic agents, argon beam coagulation, direct suture repair, partial resection, wrapping the spleen with absorbable mesh, and splenic reimplantation. Pledgets are generally used when suturing splenic lacerations and margins of segmental resections. It is important to confirm hemostasis before closure of the midline fascia. Packing of the spleen in damage control surgery should be discouraged because splenectomy is fairly simple and definitive. Splenic reimplantation in a patient without significant bacterial contamination is a safe but unproven method of preserving splenic function to protect against overwhelming postsplenectomy sepsis.45

 

  
Western Trauma Association © 2002-2009, All Rights Reserved