Damage control surgery for splenic trauma: "preserve an organ - preserve a life"
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| Format: | Artículo científico |
| Language: | en |
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Universidad del Valle
2021
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| _version_ | 1876428904632156160 |
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| author | Carlos Serna |
| author_facet | Carlos Serna |
| contents | Damage control surgery for splenic trauma: "preserve an organ - preserve a life" Carlos Serna José Julián Serna Yaset Caicedo Natalia Padilla Linda M. Gallego Alexander Salcedo Fernando Rodríguez-Holguín Adolfo González-Hadad Alberto García Mario Alain Herrera Michael W. Parra Carlos A. Ordoñez Medicina REBOA Spleen negative laparotomy splenectomy The spleen is one of the most commonly injured solid organs of the abdominal cavity and an early diagnosis can reduce the associated mortality. Over the past couple of decades, management of splenic injuries has evolved to a prefered non-operative approach even in severely injured cases. However, the optimal surgical management of splenic trauma in severely injured patients remains controversial. This article aims to present an algorithm for the management of splenic trauma in severely injured patients, that includes basic principles of damage control surgery and is based on the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia. The choice between a conservative or a surgical approach depends on the hemodynamic status of the patient. In hemodynamically stable patients, a computed tomography angiogram should be performed to determine if non-operative management is feasible and if angioembolization is required. While hemodynamically unstable patients should be transferred immediately to the operating room for damage control surgery, which includes splenic packing and placement of a negative pressure dressing, followed by angiography with embolization of any ongoing arterial bleeding. It is our recommendation that both damage control principles and emerging endovascular technologies should be applied to achieve splenic salvage when possible. However, if surgical bleeding persists a splenectomy may be required as a definitive lifesaving maneuver. 2021 reseña 0120-8322 https://www.redalyc.org/articulo.oa?id=28366681008 https://www.redalyc.org/journal/283/28366681008/ https://www.redalyc.org/journal/283/28366681008/html/ https://www.redalyc.org/journal/283/28366681008/28366681008.epub https://www.redalyc.org/journal/283/28366681008/movil 10.25100/cm.v52i2.4794 en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.2 Vol.52 |
| format | Artículo científico |
| id | redalyc_28366681008 |
| institution | Redalyc |
| language | en |
| publishDate | 2021 |
| publisher | Universidad del Valle |
| spellingShingle | Damage control surgery for splenic trauma: "preserve an organ - preserve a life" Carlos Serna Medicina REBOA Spleen negative laparotomy splenectomy Damage control surgery for splenic trauma: "preserve an organ - preserve a life" Carlos Serna José Julián Serna Yaset Caicedo Natalia Padilla Linda M. Gallego Alexander Salcedo Fernando Rodríguez-Holguín Adolfo González-Hadad Alberto García Mario Alain Herrera Michael W. Parra Carlos A. Ordoñez Medicina REBOA Spleen negative laparotomy splenectomy The spleen is one of the most commonly injured solid organs of the abdominal cavity and an early diagnosis can reduce the associated mortality. Over the past couple of decades, management of splenic injuries has evolved to a prefered non-operative approach even in severely injured cases. However, the optimal surgical management of splenic trauma in severely injured patients remains controversial. This article aims to present an algorithm for the management of splenic trauma in severely injured patients, that includes basic principles of damage control surgery and is based on the experience obtained by the Trauma and Emergency Surgery Group (CTE) of Cali, Colombia. The choice between a conservative or a surgical approach depends on the hemodynamic status of the patient. In hemodynamically stable patients, a computed tomography angiogram should be performed to determine if non-operative management is feasible and if angioembolization is required. While hemodynamically unstable patients should be transferred immediately to the operating room for damage control surgery, which includes splenic packing and placement of a negative pressure dressing, followed by angiography with embolization of any ongoing arterial bleeding. It is our recommendation that both damage control principles and emerging endovascular technologies should be applied to achieve splenic salvage when possible. However, if surgical bleeding persists a splenectomy may be required as a definitive lifesaving maneuver. 2021 reseña 0120-8322 https://www.redalyc.org/articulo.oa?id=28366681008 https://www.redalyc.org/journal/283/28366681008/ https://www.redalyc.org/journal/283/28366681008/html/ https://www.redalyc.org/journal/283/28366681008/28366681008.epub https://www.redalyc.org/journal/283/28366681008/movil 10.25100/cm.v52i2.4794 en http://www.redalyc.org/revista.oa?id=283 Colombia Médica application/pdf Universidad del Valle Colombia Médica (Colombia) Num.2 Vol.52 |
| title | Damage control surgery for splenic trauma: "preserve an organ - preserve a life" |
| topic | Medicina REBOA Spleen negative laparotomy splenectomy |
| url | https://www.redalyc.org/articulo.oa?id=28366681008 https://www.redalyc.org/journal/283/28366681008/ https://www.redalyc.org/journal/283/28366681008/html/ https://www.redalyc.org/journal/283/28366681008/28366681008.epub https://www.redalyc.org/journal/283/28366681008/movil |