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The Management of Splenic Trauma in a Trauma System
Melinda R. Molin, MD;
Steven R. Shackford, MD
Arch Surg. 1990;125(7):840-843.
Abstract
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).
(Arch Surg. 1990;125:840-843)
Author Affiliations
From the University of California School of Medicine, San Diego (Dr Molin), and the University of Vermont College of Medicine, Burlington (Dr Shackford).
Footnotes
Accepted for publication April 4, 1990.
Read before the Annual Meeting of the Western Trauma Surgical Association, St Louis, Mo, November 14, 1989.
Reprint requests to the University of Vermont College of Medicine, Department of Surgery, Given Building D-319, Burlington, VT 05405 (Dr Shackford).
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