Conventional techniques for the repair of wounds of the liver in man include suture-ligatures, mattress sutures, electrocoagulation, hemostatic agents such as absorbable gelatin sponge (Gelfoam), gauze packing, and routine external drainage, or any combination of these measures. Debridement and partial resections are occasionally indicated. Crosthwait et al have summarized the current management of hepatic wounds. These methods leave much to be desired as regards rapid, secure hemostasis, control of surface leakage, reliable reconstitution, and the preservation of functional tissue. Hepatic wounds pose a particularly formidable problem because of vascularity, softness, and friability of this organ, which makes suturing difficult, and they are notoriously associated with secondary hemorrhage, bile leakage, and sepsis.
The spleen is a soft, friable, vascular structure, and repair of this organ is rarely undertaken; splenectomy is universally advocated.
Wounds of the renal parenchyma are amenable to conventional methods of repair, but nephrectomy is occasionally indicated.
WOJNAR VS, GERMAN AI, MOGHUL TH, SCARANO D. Liver, Spleen, and Kidney WoundsExperimental Repair With Topical Adhesive. Arch Surg. 1964;89(2):237-243. doi:10.1001/archsurg.1964.01320020001001