Experimental and clinical evaluation of the splenic capping method in the treatment of injured spleens.
Polyglycolic acid elastic mesh was tailored and wrapped around the entire surface of experimentally injured spleens in 11 dogs, while carefully avoiding the splenic hilum, like a "hair-net", to achieve complete hemostasis by compression. All 11 dogs survived the experiment with no postoperative bleeding observed. Histological examination, performed 6 weeks postoperatively, revealed histiocytes, fibroblastic proliferation with collagen and cellular collagenized fibrous tissue forming a neocapsule covering the spleen. Hematologically, the platelet count was increased at 2 weeks postoperatively, but subsequently decreased to within the normal levels by 4 weeks. We employed this splenic capping method clinically in four cases to avoid splenectomy and sufficient hemostasis with ultimate splenic recovery was achieved in each case without any abscess formation, postoperative bleeding, or complications related to the use of the mesh. These experimental and clinical results thus indicate the efficacy and safety of the splenic capping method for preserving the injured spleen.
Takeda
J
J
First Department of Surgery, Kurume University School of Medicine, Japan.
Hashimoto
K
K
Tanaka
M
M
Iwai
H
H
Kakegawa
T
T
D000328:Adult; D000368:Aged; D000673:Amputation, Traumatic / Q000601:surgery; D000818:Animals; D003094:Collagen; D004285:Dogs; D005260:Female; D005347:Fibroblasts / Q000473:pathology; D006470:Hemorrhage / Q000517:prevention & control; D006488:Hemostasis, Surgical / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D011100:Polyglycolic Acid; D013154:Spleen / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D013158:Splenic Diseases / Q000517:prevention & control; D013274:Stomach Neoplasms / Q000601:surgery; D013526:Surgical Mesh; D014945:Wound Healing
D011100:Polyglycolic Acid; D003094:Collagen