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July 1990

The Management of Splenic Trauma in a Trauma System

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).

Arch Surg. 1990;125(7):840-843. 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).

(Arch Surg. 1990;125:840-843)