Prevention of pelvic sepsis in major open pelviperineal injury.
Compound pelvic fractures are deemed to be one of the most severe orthopaedic injuries with an extremely high morbidity and mortality. After the initial resuscitation phase the prevention of pelvic sepsis is one of the main treatment goals for patients with an open pelvic fracture. If there is a suspicion of a rectal injury or if the wounds are in the perineal area, The Princess Alexandra Hospital's management plan includes early faecal diversion combined with vigorous soft tissue debridement, VAC(®) therapy and (if indicated) external fixation of the pelvic fracture. We present our flowchart for the treatment of trauma patients with compound pelvic fractures illustrated by a case report describing a 32 year old patient who sustained an open pelvic ring injury in a workplace accident. The aim of this paper is to underline the importance of a safe, straightforward approach to compound pelvic fractures.
Department of Surgery-Trauma Service, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4012, Australia. geertje_govaert@health.qld.gov.au
Geertje
G
Govaert
Mehan
M
Siriwardhane
Michael
M
Hatzifotis
Lawrence
L
Malisano
Michael
M
Schuetz
D000007:Abdominal Injuries / Q000601:surgery; D000328:Adult; D003125:Colostomy; D003646:Debridement / Q000379:methods; D005592:Fracture Fixation; D005597:Fractures, Open / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D010388:Pelvis / Q000293:injuries* / Q000601:surgery; D010502:Perineum / Q000293:injuries / Q000601:surgery; D012446:Sacroiliac Joint / Q000293:injuries / Q000601:surgery; D018805:Sepsis / Q000517:prevention & control*; D017695:Soft Tissue Injuries / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome; D014566:Urogenital System / Q000293:injuries / Q000601:surgery