RT Journal
A1 STAIN SC, YELLIN AE, DONOVAN AJ
T1 HEpatic packing in major hepatic trauma-reply
JF Archives of Surgery
JO Archives of Surgery
YR 1989
FD April 1
VO 124
IS 4
SP 509
OP 509
DO 10.1001/archsurg.1989.01410040118031
UL http://dx.doi.org/10.1001/archsurg.1989.01410040118031
AB In Reply.—Dr Ferguson's well-documented case demonstrates the value of packing a major hepatic and juxtahepatic venous injury in two clinical situations. The first indication was as a temporary expedient to permit transfer of the patient to a site more suitable for definitive treatment. We cited Blumgart and colleagues' report1 in this regard; this clearly is a useful expedient. The second was to permit correction of hypothermia that develops intraoperatively with concurrent coagulopathy. Both Feliciano and associates2 and Cogbill and associates3 have reported favorable results with packing of the hepatic wound after repair of major venous injury with ensuing coagulopathy. The survival rates of their patients were 34% and 59%, respectively. We have recently had a favorable experience in a similar circumstance.Both Feliciano et al2 and Cogbill et al3 and their respective associates also reported that packing was ineffective when undertaken as a desperation measure