List Archives

Tue Sep 5 15:13:27 BST 2006

In a message dated 9/5/2006 9:05:56 A.M. Central Standard Time,  
RMungai at ETHUS.JNJ.com writes:

I'd like  to ask what you and other trauma surgeons are using in the
operating room  (OR) with regards to organ (Kidney, Liver & Spleen) salvage
and support  in emergency trauma cases?

Is what you are currently using  effective/efficient in achieving hemostasis
of the traumatized kidney,  liver or spleen ?

1.    Spleen salvage in the adult, where simple suture  is not possible, and 
where one needs to resort to using a vicryl mesh covering  is just going too 
far.    Take out the spleen    

2    Vicryl meshes for kidney wraps also are rarely  used currently.   Simple 
traditional suturing and argon beam  coagulator

3.    Liver - direct suture of bleeding.  packing,  and arteriography.    I 
have never really been happy with ANY of  the liver wrapping techniques.   

4.   Surgeons should be adept in understanding that bleeding  vessels best 
respond to direct individual ligation, rather than trying to resort  to wraps, 
IV hemostasis, and topical agents on the outside of a pressurized  artery or 
vein.   

k

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Vicryl Mesh Bag for Kidney, Spleen & Organ support