Sturm J, Saeger H D, Hagmüller E, Trede M
Chirurgische Klinik, Universität Heidelberg.
Chirurg. 1994 Apr;65(4):382-7.
Mesh-wrapping is a quick and technically feasible method to achieve definitive hemostasis in severe liver trauma. It can be combined ideally with conventional procedures. Mesh-wrapping has the same spectrum of indications in severe liver trauma as packing with gauze pads. Whereas packing seems to be superior in cases with bleeding from juxta-caval injuries, Mesh-wrapping is considered to be superior in coagulopathy. The Mesh-wrapping technique provides a highly selective, tight compression confined to the liver and does not produce an increased intraabdominal pressure. The mesh is resorbable and therefore reoperation for removal is not necessary. In cases of postoperative fluid collections the Mesh-wrapping can easily be punctured. Because of its own bacteriostatic capacity Mesh-wrapping seems to be superior when the patient has concomitant gastrointestinal injuries. In summary we think that Mesh-wrapping is a useful alternative in the more conservative, organ preserving spectrum of liver trauma management.
网膜包裹术是在严重肝外伤中实现确切止血的一种快速且技术上可行的方法。它能与传统手术完美结合。网膜包裹术在严重肝外伤中的适应证范围与用纱布垫填塞相同。虽然在腔静脉旁损伤出血的病例中填塞似乎更具优势，但网膜包裹术在凝血病患者中被认为更具优势。网膜包裹技术能对肝脏进行高度选择性、紧密的压迫，且不会导致腹内压升高。该网膜是可吸收的，因此无需再次手术取出。在术后出现积液的情况下，网膜包裹物可轻松穿刺。由于其自身的抑菌能力，当患者伴有胃肠道损伤时，网膜包裹术似乎更具优势。总之，我们认为在更保守的、保留器官的肝外伤处理方法中，网膜包裹术是一种有用的替代方法。
