title: Mesh wrapping for severe hepatic injury: a beneficial option in the trauma surgeon's armamentarium.
abstract: BACKGROUND
  The purpose of this study was to assess the efficacy of absorbable mesh wrapping (MW) versus perihepatic packing (HP) for severe hepatic injury.
  
  
  METHODS
  From January 2001 to December 2012, data were collected for MW patients with hepatic injury. Patients who underwent HP were matched with MW patients by injury mechanism, liver injury grade, Injury Severity Score, and age.
  
  
  RESULTS
  Twenty-six MW and twenty-six HP patients were matched. Eighteen blunt and 8 penetrating injuries were present in each group. There were 9 (35%) mortalities in the MW group and 16 (62%) in the HP groups (P = .03). Average transfusions were 12.0 and 24.5 (P = .03) packed red blood cells in the MW and HP groups, respectively. Average laparotomies per survivors were 1.3 for the MW and 3.1 for the HP groups (P = .01). Average length of stay for survivors was 19 and 47 (P = .04) days in the MW and HP groups, respectively.
  
  
  CONCLUSIONS
  MW for hepatic injuries can significantly decrease mortality, transfusions, laparotomies, and length of stay.
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Kennedy
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Sidney B
authors.initials: SB
authors.lastname: Brevard
authors.affiliation: Department of Surgery, University of Alabama-Birmingham, Birmingham, AL, USA.
authors.forename: Patrick
authors.initials: P
authors.lastname: Bosarge
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Jon D
authors.initials: JD
authors.lastname: Simmons
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Frotan
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Jeremy A
authors.initials: JA
authors.lastname: Baker
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Lynda
authors.initials: L
authors.lastname: Tuart
authors.affiliation: Department of Surgery, University of South Alabama, Mobile, AL, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Pritchett
authors.affiliation: Department of Surgery, Loyola University Medical Center, Maywood, IL, USA. Electronic address: richard.gonzalez@lumc.edu.
authors.forename: Richard P
authors.initials: RP
authors.lastname: Gonzalez
mesh_terms: D000007:Abdominal Injuries / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D002983:Clinical Competence; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013526:Surgical Mesh; D015996:Survival Rate / Q000639:trends; D014193:Trauma Centers; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D055815:Young Adult
keywords: Absorbable; Hepatorrhaphy; Injury; Liver; Mesh; Repair; Wrap