The management of splenic trauma in a trauma system.
Large teaching centers have reported splenic salvage rates of 40% to 50% in adults after splenic trauma. It is unknown whether similar salvage rates can be achieved safely in community trauma centers with a lower volume of patients and less experience. Between August 1984 and August 1988, 117 patients with splenic injury were treated at a level I center and 311 were treated at four level II centers. Splenectomy was performed in 252 patients (59%), splenorrhaphy was performed in 160 patients (37%), and 16 patients (4%) were observed. While the splenic salvage rate was higher at the level I center (50% vs 38%), selective splenorrhaphy was successful in the level II centers where the volume of splenic injury was lower (15 to 25 cases per year).
University of California School of Medicine, San Diego.
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MR
Molin
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SR
Shackford
D000328:Adult; D001803:Blood Transfusion; D002140:California; D006801:Humans; D015601:Injury Severity Score; D015337:Multicenter Studies as Topic; D011183:Postoperative Complications; D012086:Reoperation; D013154:Spleen / Q000293:injuries* / Q000601:surgery; D013156:Splenectomy; D014193:Trauma Centers; D014218:Triage; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000601:surgery*