Spleen suture repair

If the scope of spleen laceration is limited, spleen suture repair should be performed. Treating diseases: rupture Indication If the scope of spleen laceration is limited, spleen suture repair should be performed. Contraindications 1. Combine abdominal cavity contamination caused by damage to hollow organs. 2. The spleen is extensively ruptured, and the spleen or spleen is broken, or the spleen and segmental vessels are damaged, and the repair can not be repaired. 3. Pathological splenomegaly occurs spontaneous spleen rupture. Preoperative preparation 1. Emergency surgery: When emergency surgery is required when the spleen ruptures, hemorrhagic shock should be prevented at the same time as preoperative preparation, so that the operation can be performed in the shortest time. Patients with severe spleen rupture, due to a large number of internal hemorrhage, often accompanied by hemorrhagic shock, need a large number of rapid blood transfusion, if necessary, arterial pressure transfusion, and adequate blood preparation. At the same time, attention should be paid to the multiple injuries of other organs and given treatment. Gastrointestinal decompression should be performed before surgery to prevent the stomach from expanding and hindering the exposure. Sufficient antibiotics should also be given to prevent infection. When the preoperative preparation is basically completed and the surgical instruments are ready, the operation should be stopped as soon as possible under anti-shock treatment, and should not wait for shock to correct. 2. Selective surgery: Chronic spleen diseases other than rupture should be elective surgery. Pay attention to improve the general condition, a small amount of blood transfusion, protect liver function, correct coagulation insufficiency, and perform necessary laboratory tests (including hemoglobin measurement, red blood cell count, total white blood cell count and classification, platelet count, vascular fragility test, bleeding time, clotting time, Prothrombin time, etc.). Gastrointestinal decompression should be performed before operation. For patients with esophageal varices, soft stomach tube should be selected. A small amount of liquid paraffin should be taken before the lower tube. Pay special attention to prevent major bleeding. Blood should be prepared before surgery to prepare for blood transfusion. Sufficient antibiotics should also be given. Surgical procedure 1. Remove blood clots, spleen subcapsular hematoma and inactivated spleen tissue from spleen wounds. 2. The wound surface is sutured with a thin thread to stop bleeding. 3. For superficial lacerations (within 2 cm of wound), it can be sewn with a 1-0 to 2-0 chrome gut or a 7-0 silk thread. For deeper wounds, the suture u-shaped suture parallel to the wound edge and deep to the bottom of the wound can be made first, and then the wound is closed. The ruptured omentum or gelatin sponge block can be filled in the wound cavity to help reduce hemostasis during hemostasis and ligation.

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