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Unfallchirurg. 2013 Jan;116(1):47-52. doi: 10.1007/s00113-011-2044-4.

[Treatment practice in patients with isolated blunt splenic injuries. A survey of Swiss traumatologists].

[Article in German]

Author information

1
Department of Trauma and Surgical Critical Care, University of Southern California, Los Angeles, 1200 North State Street, Los Angeles, California, USA. beat.schnuriger@gmail.com

Abstract

BACKGROUND:

The non-operative management (NOM) of blunt splenic injuries has gained widespread acceptance. However, there are still many controversies regarding follow-up of these patients. The purpose of this study was to survey active members of the Swiss Society of General and Trauma Surgery (SGAUC) to determine their practices regarding the NOM of isolated splenic injuries.

MATERIALS AND METHODS:

A survey of active SGAUC members with a written questionnaire was carried out. The questionnaire was designed to elicit information about personal and facility demographics, diagnostic practices, in-hospital management, preferred follow-up imaging and return to activity.

RESULTS:

Out of 165 SGAUC members 52 (31.5%) completed the survey and 62.8% of all main trauma facilities in Switzerland were covered by the sample. Of the respondents 14 (26.9%) have a protocol in place for treating patients with splenic injuries. For initial imaging in hemodynamically stable patients 82.7% of respondents preferred ultrasonography (US). In cases of suspected splenic injury 19.2% of respondents would abstain from further imaging. In cases of contrast extravasation from the spleen half of the respondents would take no specific action. For low-grade injuries 86.5% chose to admit patients for an average of 1.6 days (range 0-4 days) with a continuously monitored bed. No differences in post-discharge activity restrictions between moderate and high-grade splenic injuries were found.

CONCLUSION:

The present survey showed considerable practice variation in several important aspects of the NOM of splenic injuries. Not performing further CT scans in patients with suspected splenic injuries and not intervening in cases of a contrast extravasation were the most important discrepancies to the current literature. Standardization of the NOM of splenic injuries may be of great benefit for both surgeons and patients.

PMID:
21604027
DOI:
10.1007/s00113-011-2044-4
[Indexed for MEDLINE]
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