title: Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery).
abstract: Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients.Hemodynamically Unstable Pelvic Trauma is a frequent death cause among people who sustain blunt trauma. We present the results of the First Italian Consensus Conference.
authors.affiliation: First General Surgery Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy. smagnone@hpg23.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Magnone
authors.forename: Federico
authors.initials: F
authors.lastname: Coccolini
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredi
authors.forename: Dario
authors.initials: D
authors.lastname: Piazzalunga
authors.forename: Roberto
authors.initials: R
authors.lastname: Agazzi
authors.forename: Claudio
authors.initials: C
authors.lastname: Arici
authors.forename: Marco
authors.initials: M
authors.lastname: Barozzi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Bellanova
authors.forename: Alberto
authors.initials: A
authors.lastname: Belluati
authors.forename: Giorgio
authors.initials: G
authors.lastname: Berlot
authors.forename: Walter
authors.initials: W
authors.lastname: Biffl
authors.forename: Stefania
authors.initials: S
authors.lastname: Camagni
authors.forename: Luca
authors.initials: L
authors.lastname: Campanati
authors.forename: Claudio Carlo
authors.initials: CC
authors.lastname: Castelli
authors.forename: Fausto
authors.initials: F
authors.lastname: Catena
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Chiara
authors.forename: Nicola
authors.initials: N
authors.lastname: Colaianni
authors.forename: Salvatore
authors.initials: S
authors.lastname: De Masi
authors.forename: Salomone
authors.initials: S
authors.lastname: Di Saverio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Dodi
authors.forename: Andrea
authors.initials: A
authors.lastname: Fabbri
authors.forename: Giovanni
authors.initials: G
authors.lastname: Faustinelli
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gambale
authors.forename: Michela Giulii
authors.initials: MG
authors.lastname: Capponi
authors.forename: Marco
authors.initials: M
authors.lastname: Lotti
authors.forename: Gianmariano
authors.initials: G
authors.lastname: Marchesi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Massè
authors.forename: Tiziana
authors.initials: T
authors.lastname: Mastropietro
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nardi
authors.forename: Raffaella
authors.initials: R
authors.lastname: Niola
authors.forename: Gabriela Elisa
authors.initials: GE
authors.lastname: Nita
authors.forename: Michele
authors.initials: M
authors.lastname: Pisano
authors.forename: Elia
authors.initials: E
authors.lastname: Poiasina
authors.forename: Eugenio
authors.initials: E
authors.lastname: Poletti
authors.forename: Antonio
authors.initials: A
authors.lastname: Rampoldi
authors.forename: Sergio
authors.initials: S
authors.lastname: Ribaldi
authors.forename: Gennaro
authors.initials: G
authors.lastname: Rispoli
authors.forename: Luigi
authors.initials: L
authors.lastname: Rizzi
authors.forename: Valter
authors.initials: V
authors.lastname: Sonzogni
authors.forename: Gregorio
authors.initials: G
authors.lastname: Tugnoli
authors.forename: Luca
authors.initials: L
authors.lastname: Ansaloni