New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept
Abstract Background The liver is the most injured organ following abdominal trauma. Uncontrolled bleeding remains the main cause of early liver injury-related death, with a mortality rate of 50–54% in the first 24 h after admission and with 80% of operative deaths. Packing and reoperation account fo...
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doaj-9bb1e53ad8b24be5a2f9c0792a325d8f2020-12-20T12:20:31ZengBMCWorld Journal of Emergency Surgery1749-79222019-12-011411910.1186/s13017-019-0277-7New hemostatic device for grade IV–V liver injury in porcine model: a proof of conceptJuan José Segura-Sampedro0Cristina Pineño-Flores1Andrea Craus-Miguel2Rafael Morales-Soriano3Francesc Xavier González-Argente4General & Digestive Surgery Department, University Hospital Son EspasesGeneral & Digestive Surgery Department, University Hospital Son EspasesGeneral & Digestive Surgery Department, University Hospital Son EspasesGeneral & Digestive Surgery Department, University Hospital Son EspasesGeneral & Digestive Surgery Department, University Hospital Son EspasesAbstract Background The liver is the most injured organ following abdominal trauma. Uncontrolled bleeding remains the main cause of early liver injury-related death, with a mortality rate of 50–54% in the first 24 h after admission and with 80% of operative deaths. Packing and reoperation account for the increased survival in severe liver trauma, and they are recommended for severe liver injuries (grades IV–V). Perihepatic packing can lead to several potential complications. An excessive packing can cause complications due to abdominal compartment syndrome, while a soft packing may be ineffective, and thus, bleeding can continue inadvertently with the consequent hypovolemic shock and potentially death. Methods We designed a new vacuum-based device to perform perihepatic packing without the negative side-effects of the classic technique. We conducted a prospective pilot feasibility study in a porcine model. We compared the traditional perihepatic packing (PHP) (n = 2) with the new VacBagPack device (VBP) (n = 2). Results Both pigs survived with the new device and showed an equivalent outcome to the one that survived in the traditional technique group. Blood tests were similar too. This suggests that VBP could be at least as effective as traditional PHP. Conclusions We establish a first step towards the development of a new packing device. A new study with a bigger sample size still in pigs will be conducted. Also, an industrial model of the device is currently in production.https://doi.org/10.1186/s13017-019-0277-7Abdominal traumaLiver injuryHemostatic deviceDamage control |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Juan José Segura-Sampedro Cristina Pineño-Flores Andrea Craus-Miguel Rafael Morales-Soriano Francesc Xavier González-Argente |
spellingShingle |
Juan José Segura-Sampedro Cristina Pineño-Flores Andrea Craus-Miguel Rafael Morales-Soriano Francesc Xavier González-Argente New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept World Journal of Emergency Surgery Abdominal trauma Liver injury Hemostatic device Damage control |
author_facet |
Juan José Segura-Sampedro Cristina Pineño-Flores Andrea Craus-Miguel Rafael Morales-Soriano Francesc Xavier González-Argente |
author_sort |
Juan José Segura-Sampedro |
title |
New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept |
title_short |
New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept |
title_full |
New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept |
title_fullStr |
New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept |
title_full_unstemmed |
New hemostatic device for grade IV–V liver injury in porcine model: a proof of concept |
title_sort |
new hemostatic device for grade iv–v liver injury in porcine model: a proof of concept |
publisher |
BMC |
series |
World Journal of Emergency Surgery |
issn |
1749-7922 |
publishDate |
2019-12-01 |
description |
Abstract Background The liver is the most injured organ following abdominal trauma. Uncontrolled bleeding remains the main cause of early liver injury-related death, with a mortality rate of 50–54% in the first 24 h after admission and with 80% of operative deaths. Packing and reoperation account for the increased survival in severe liver trauma, and they are recommended for severe liver injuries (grades IV–V). Perihepatic packing can lead to several potential complications. An excessive packing can cause complications due to abdominal compartment syndrome, while a soft packing may be ineffective, and thus, bleeding can continue inadvertently with the consequent hypovolemic shock and potentially death. Methods We designed a new vacuum-based device to perform perihepatic packing without the negative side-effects of the classic technique. We conducted a prospective pilot feasibility study in a porcine model. We compared the traditional perihepatic packing (PHP) (n = 2) with the new VacBagPack device (VBP) (n = 2). Results Both pigs survived with the new device and showed an equivalent outcome to the one that survived in the traditional technique group. Blood tests were similar too. This suggests that VBP could be at least as effective as traditional PHP. Conclusions We establish a first step towards the development of a new packing device. A new study with a bigger sample size still in pigs will be conducted. Also, an industrial model of the device is currently in production. |
topic |
Abdominal trauma Liver injury Hemostatic device Damage control |
url |
https://doi.org/10.1186/s13017-019-0277-7 |
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