© 2015 Elsevier Inc. All rights reserved. Background The purpose of this study was to assess the efficacy of absorbable mesh wrapping (MW) versus perihepatic packing (HP) for severe hepatic injury. Methods From January 2001 to December 2012, data were collected for MW patients with hepatic injury. Patients who underwent HP were matched with MW patients by injury mechanism, liver injury grade, Injury Severity Score, and age. Results Twenty-six MW and twenty-six HP patients were matched. Eighteen blunt and 8 penetrating injuries were present in each group. There were 9 (35%) mortalities in the MW group and 16 (62%) in the HP groups (P =.03). Average transfusions were 12.0 and 24.5 (P =.03) packed red blood cells in the MW and HP groups, respectively. Average laparotomies per survivors were 1.3 for the MW and 3.1 for the HP groups (P =.01). Average length of stay for survivors was 19 and 47 (P =.04) days in the MW and HP groups, respectively. Conclusion MW for hepatic injuries can significantly decrease mortality, transfusions, laparotomies, and length of stay.