Simple and Safe Packing Method for High-Grade Liver Injuries


1 Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran

2 Department of Surgery, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, IR Iran



Background: Injury to the liver is a commonly encountered problem in trauma cases and is a frequent cause of morbidity and mortality. Because gauze packing is easy to use and has the potential for rapid hemorrhage control, it is the most commonly used method for patients with severe liver injuries, particularly those with coagulopathy.
Objectives: In this study, OpSite sheets were used to make three-layer packs for decreasing the complication associated with removing gauze packing.
Patients and Methods: Twenty male patients with grade IV or V liver injuries that required laparotomy were enrolled in the study. Ten patients were treated using conventional packing, while the other 10 were treated using the three-layer pack. In the case group, the liver was mobilized as much as possible. The three-layer pack was then placed at the site of liver damage and extended onto the liver surface, and the other pads were placed on top of this pad. After 72 h, reoperation was performed, the packs were removed, and the packs causing injury were recorded. Additionally, if rebleeding due to the adhesive bands of the pack was observed, the blood was suctioned and bleeding volume was measured. Data were analyzed using the Mann–Whitney test.
Results: Patients in the case and control groups were similar in age and admission vital signs. During the second operation, the bleeding volumes measured in the case and control groups were 66 ± 27.01 mL and 152 ± 85.4 mL, respectively. There was some pad-induced damage after the removal of the pad in the control group.
Conclusions: Our study has provided a simple and safe packing method for high-grade liver injuries.