Factors affecting morbidity following hepatic trauma. A prospective analysis of 482 injuries
| Autor: | Martin A. Croce, Gregory G. Stanford, Lynda W. Payne, Guy R. Voeller, Timothy C. Fabian, Kenneth A. Kudsk, Eugene C. Mangiante |
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| Rok vydání: | 1991 |
| Předmět: |
Suction (medicine)
Adult medicine.medical_specialty Adolescent Liver Abscess Wounds Penetrating Suction Wounds Nonpenetrating Hepatic trauma Random Allocation Blunt medicine Craniocerebral Trauma Humans Prospective Studies Risk factor Prospective cohort study Abscess Aged business.industry Middle Aged medicine.disease Surgery Abdominal trauma Liver Perihepatic Abscess Drainage business Research Article |
| Zdroj: | Annals of surgery. 213(6) |
| ISSN: | 0003-4932 |
| Popis: | 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 less than 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. |
| Databáze: | OpenAIRE |
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