Preperitoneal pelvic packing is effective for hemorrhage control in open pelvic fractures

Open pelvic fractures are life-threatening injuries. Preperitoneal pelvic packing (PPP) has been suggested to be ineffective for hemorrhage control in open pelvic fractures. We hypothesize that PPP is effective at hemorrhage control in patients with open pelvic fractures and reduces mortality. Patie...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of surgery 2018-04, Vol.215 (4), p.675-677
Main Authors: Moskowitz, Eliza E., Burlew, Clay Cothren, Moore, Ernest E., Pieracci, Fredric M., Fox, Charles J., Campion, Eric M., Lawless, Ryan A., Cohen, Mitchell J.
Format: Article
Language:English
Subjects:
Adult
Antibiotics
Brain
Emergency medical care
Female
Fracture Fixation - methods
Fractures
Fractures, Bone - complications
Fractures, Bone - mortality
Fractures, Bone - surgery
Fractures, Open - complications
Fractures, Open - mortality
Fractures, Open - surgery
Head injuries
Hemorrhage
Hemorrhage - etiology
Hemorrhage - mortality
Hemorrhage - prevention & control
Hemostatic Techniques
Humans
Injuries
Injury Severity Score
Intensive care
Male
Mortality
Open pelvic fractures
Packaging
Patients
Pelvic Bones - injuries
Pelvic fractures
Preperitoneal pelvic packing
Rectum
Shock
Surgeons
Surgery
Trauma
Trauma centers
Traumatic brain injury
Treatment Outcome
Vagina
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Open pelvic fractures are life-threatening injuries. Preperitoneal pelvic packing (PPP) has been suggested to be ineffective for hemorrhage control in open pelvic fractures. We hypothesize that PPP is effective at hemorrhage control in patients with open pelvic fractures and reduces mortality. Patients undergoing PPP from 2005 to 2015 were analyzed. Patients with open pelvic fractures were defined as direct communication of the bony injury with overlying soft tissue, vagina, or rectum. During the 10-year study, 126 patients underwent PPP; 14 (11%) sustained an open pelvic fracture. After PPP, 1 patient (7%) underwent angioembolization with a documented arterial blush. PPP controlled pelvic hemorrhage in all patients. Overall mortality rate was 7% with one death due to traumatic brain injury. PPP is effective for hemorrhage control in patients with open pelvic fractures. PPP should be used in a standard protocol for hemodynamically unstable patients with pelvic fractures regardless of associated perineal injuries.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2017.11.024