FACTORS AFFECTING MORBIDITY FOLLOWING HEPATIC-TRAUMA - A PROSPECTIVE ANALYSIS OF 482 INJURIES

被引:122
作者
FABIAN, TC [1 ]
CROCE, MA [1 ]
STANFORD, GG [1 ]
PAYNE, LW [1 ]
MANGIANTE, EC [1 ]
VOELLER, GR [1 ]
KUDSK, KA [1 ]
机构
[1] UNIV TENNESSEE,CTR HLTH SCI,DEPT SURG,MEMPHIS,TN 38163
关键词
D O I
10.1097/00000658-199106000-00003
中图分类号
R61 [外科手术学];
学科分类号
摘要
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 < 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.
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页码:540 / 548
页数:9
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