Emergency treatment of splenic injury in a novel mobile minimally invasive interventional shelter following disaster: a feasibility study

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Yaling Han²  Geng Wang²  Fei Li²  Xiaozeng Wang²  Lijun Zhao²  Fengqi Xuan²  Jingyang Sun²  Ming Liang²  Jingjing Rong¹  Tianming Yao² 

[1] Third Military Medical University, Chongqing 400038, China;Department of Cardiology, The general hospital of Shenyang Military Region, Shenyang 110016, China

关键词: Shelter;    Interventional therapy;    Emergency;    Splenic injury;   

Others  :  1152085
DOI  :  10.1186/s13049-014-0044-4

 received in 2014-03-17, accepted in 2014-07-23,  发布年份 2014

【 摘 要 】

Background

There has been an increase in natural disasters in recent years, which leads to a great number of injuries and deaths. It still remains an unsolved problem to treat patients with vascular injury of solid organs effectively following natural disasters, but on-spot emergency interventional transcatheter arterial embolization (TAE) has been highly recommended to cure serious vascular injury of solid organs nowadays. Spleen is the most vulnerable abdominal organ, severe arterial hemorrhage of which can cause death if untreated timely. In this research, we aimed to study the possibility of performing emergency surgical intervention in mobile minimally invasive interventional shelter for splenic injury in the case of natural disasters.

Methods

First, the mobile minimally invasive interventional shelter was unfolded in the field, and then disinfection and preoperative preparation were performed immediately. Eight large animal models of splenic injury were created, and angiograms were performed using a digital subtraction angiography machine in the mobile minimally invasive interventional shelter, and then the hemostatic embolizations of injured splenic artery were performed following the established convention of rapid intervention therapy. The operating time was recorded, and the survival condition and postoperative complications were observed for two weeks.

Results and discussion

The average time of unfolding the shelter, and performing disinfection and preoperative preparation was 33 ± 7 min. The number of colonies in the sterilized shelter body was 86 ± 13 cfu/m³. The average TAE time was 31 ± 7 min. All the hemostatic embolizations of splenic injury were performed successfully in the mobile minimally invasive interventional shelter during the operation. A pseudoaneurysm was found in an animal model using angiography two weeks after the operation. The primary clinical success rate of embolization was 87.5%. The two-week survival rate in all animal models of splenic injury was 100%.

Conclusions

Our findings in the current study demonstrate that the mobile minimally invasive interventional shelter can be adapted to the field perfectly and complete emergency surgical intervention for splenic injury efficiently and safely. Therefore, on-spot emergency interventional TAE for vascular injury of solid organs (e.g. spleen) in mobile minimally invasive interventional shelter is available and effective.

【 授权许可】

   
2014 Tian-ming et al.; licensee BioMed Central Ltd.

【 图 表 】

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