The benefits of preserving splenic function are well accepted but use of splenorrhaphy has some times been avoided in complex injuries because of the belief that it necessitates greater transfusion requirements than splenectomy. Excessive
transfusion
has been cited as a reason to avoid splenorrhaphy, yet studies rarely diffrentiate the risk factors that contribute to increased transfusion requirements. This study examines the use of blood transfusions for a selected group of patients whose
sole
abdominal injury was to the spleen.
To evaluate risk of transfusion, we analyzed data from 106 consecutive splenic injure patients and identified a group 41 whose only abdominal injury was to the spleen. The preoperative parameters such as blood pressure, hematocrit and injury
severity
scores were not different between splenectomy(n=25) and splenorrhaphy(n=16). Hence, all blood loss was attribute to splenic injury and/or associated non-abdominal injury.
Average total blood requirements were higher in the group of splenectomy and especially intra-operative blood requirements in the group of splenectomy(2.16±0.11) were singificantly higher than splenorrhaphy group(1.50±0.22)(p<0.001), although
the
mean
pathologic grade for splenectomy groups(3.28±0.17) was higher than the grade observed in the splenorrhaphy groups(1.63±0.1) (p<0.05). The mean number of complications were higher in the group having splenectomy vs splenorrhopahy.
We concluded 1) wen other factors such as associated injuries and pathologic splenic injury grade are controlled, splenorrhaphy does not result in greater transfusion requirement than splenectomy. 2) associated injuries account for increased
blood
loss
when present with splenic injury 3) complication rates were lower with the use of splenorrhaphy. This analysis support an aggressive approach to the use of splenorrhaphy. This analysis support an aggressive approach to the use of splenorrhaphy,
when
feasible, as it does not appear to increase transfusion requirements, or complications.
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