The management of splenic trauma in a trauma system

Arch Surg. 1990 Jul;125(7):840-3. doi: 10.1001/archsurg.1990.01410190032005.


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).

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adult
  • Blood Transfusion
  • California
  • Humans
  • Injury Severity Score
  • Multicenter Studies as Topic
  • Postoperative Complications
  • Reoperation
  • Spleen / injuries*
  • Spleen / surgery
  • Splenectomy
  • Trauma Centers*
  • Triage
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / surgery*