Indigenously crafted Polyglycolic Acid (Vicryl) Mesh for making hepatic snood as a savior for badly lacerated left lobe of Liver in a child with Blunt Trauma to Abdomen

Abstract Major liver trauma is a potentially fatal injury. Management of liver injuries has considerably changed with an inclination towards non-operative management but in about 5–10% of cases with extensive grades of liver injuries exploration becomes mandatory. Bleeding is recognized as the most common cause of death from liver injuries and surgical measures taken by operating surgeon are mainly focused on control of life-threatening exsanguination. Damage control laparotomy with packing of the abdominal cavity and abdominal organs has become a standard surgical maneuver but peri-hepatic packing has its own associated complications. Mesh wrapping of the liver has the potential to avert the need for reoperation and decrease blood product requirements. Mesh wrapping of the liver is analogous to perihepatic packing. The significant difference is that perihepatic packing applies diffuse pressure within the abdominal cavity that often affects other organs while in mesh wrapping pressure is applied directly to the organ without affecting other abdominal organs. Here we present a case of major liver laceration after blunt abdominal trauma managed with mesh wrapping where the mesh was handwoven from polyglycolic acid (Vicryl) suture material and crafted in to a snood that covered the lacerated portion of liver.