Selective fecal diversion in complex open pelvic fractures from blunt trauma.
OBJECTIVE
To review the outcomes of patients with open pelvic fractures.


METHODS
Retrospective review of medical records.


METHODS
Patients admitted from the injury scene or transferred within 24 hours to a level 1 trauma center.


METHODS
Thirty-three patients sustaining blunt trauma had pelvic fractures and adjacent wounding.


METHODS
Treatment protocol that included selective fecal diversion, measures to arrest hemorrhage and prevent wound sepsis, manage associated pelvic injuries, and provide optimal orthopedic outcomes.


METHODS
Death and sepsis.


RESULTS
Exsanguination occurred in one patient and death owing to head injuries occurred in five patients. Wound sepsis occurred in 31% of patients with colostomy and 19% without colostomy.


CONCLUSIONS
Management of open pelvic fractures requires a well-coordinated group using several techniques. Selected patients with open pelvic fractures do not require fecal diversion. Incisions for orthopedic surgery should be considered when decisions are made regarding fecal diversion.
Faringer
P D
PD
Department of Surgery, Oregon Health Sciences University, Portland.
Mullins
R J
RJ
Feliciano
P D
PD
Duwelius
P J
PJ
Trunkey
D D
DD
D000293:Adolescent; D000328:Adult; D002648:Child; D003125:Colostomy; D005260:Female; D005597:Fractures, Open / Q000601:surgery*; D006470:Hemorrhage / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010384:Pelvic Bones / Q000293:injuries*; D012189:Retrospective Studies; D014946:Wound Infection / Q000517:prevention & control; D014949:Wounds, Nonpenetrating / Q000150:complications*