title: Selective fecal diversion in complex open pelvic fractures from blunt trauma.
abstract: 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.
authors.affiliation: Department of Surgery, Oregon Health Sciences University, Portland.
authors.forename: P D
authors.initials: PD
authors.lastname: Faringer
authors.forename: R J
authors.initials: RJ
authors.lastname: Mullins
authors.forename: P D
authors.initials: PD
authors.lastname: Feliciano
authors.forename: P J
authors.initials: PJ
authors.lastname: Duwelius
authors.forename: D D
authors.initials: DD
authors.lastname: Trunkey
mesh_terms: 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*