The Efficacy of Gauze Packing in Liver Trauma: an Evaluation of the Management and Treatment of Liver Trauma

Abstract

Background: This study evaluates the management and treatment of liver trauma with emphasis on the efficacy of gauze packing.

Material and Methods: 92 patients, diagnosed with liver trauma between 01/1992 and 01/2000, were evaluated retrospectively. For clinical management reasons, a distinction was made between hemodynamically stable and unstable patients.

Results: 42 patients were clinically diagnosed as hemodynamically stable and had an average Injury Severity Score (ISS) of 24. 15 of them underwent abdominal surgery. In ten of these patients additional liver treatment was performed. The mortality among the 42 patients was two, both non-liver-related (sepsis and neurologic injury).

50 patients were considered to be hemodynamically unstable and had an average ISS of 35. All patients needed abdominal surgery. The mortality was 22 out of 50, of which seven were liver-related.

In 38 of all 92 patients only gauze packing was used as initial therapy. In twelve patients the bleeding was controlled by the first tamponade, and ten patients needed a second tamponade after an average of 2 days. Additional surgery was performed in nine patients, and seven patients died shortly after the first laparotomy. The mortality was 16, of which nine were directly liver-related.

Conclusion: Gauze packing as the initial treatment of liver trauma is considered a safe and quick method for controlling ongoing hemorrhage. Nevertheless, severe liver trauma goes with a high mortality rate.