The role of the Argon Beam Coagulator in splenic salvage.

To assess the effect of the Argon Beam Coagulator (ABC) (Bircher Medical Systems) on splenic salvage, 160 adults sustaining blunt traumatic splenic injuries over a 39 month period were evaluated. The survey period includes the first 15 months during which the ABC was used and the immediate 24 months before the use of the ABC (pre-ABC). In addition to the difference in splenic salvage in the two groups with deep laceration without hilar injury (15 versus 53 per cent), the Injury Severity Score (ISS) (44.2 versus 34.5) and Glasgow Coma Score (GCS) (11.4 versus 13.8) were significant. Multivariate logistic regression analysis revealed a significant relationship between splenic salvage and ISS (r2 = 0.27, p = 0.001) with ABC (r2 = 0.07, p = 0.02). However, if GCS is added to ISS and ABC as a factor, it does not provide additional information (p = 0.37). We conclude that the use of the ABC in the management of blunt nonhilar splenic injuries significantly improves the prospect for successful splenorrhaphy.