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).
Molin
M R
MR
University of California School of Medicine, San Diego.
Shackford
S R
SR
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*