Preperitoneal pelvic packing for exsanguinating pelvic fractures

Int Orthop. 2017 Sep;41(9):1825-1829. doi: 10.1007/s00264-017-3485-3. Epub 2017 Apr 26.

Abstract

Patients with haemodynamic instability due to pelvic fracture-related bleeding can have life-threatening haemorrhage. Management options for haemorrhage control in complex pelvic fractures include bony stabilization, angioembolization, and preperitoneal pelvic packing (PPP). The indications for PPP as well as the operative technique and outcomes will be described in this review. PPP directly addresses the bony and venous bleeding of complex pelvic fractures, which results in the majority of blood loss in exsanguinating patients. As such, PPP should be considered for pelvic fracture patients who remain haemodynamically unstable despite red cell transfusion.

Keywords: Haemodynamically unstable; Haemorrhage; Pelvic fracture; Pelvic packing.

Publication types

  • Review

MeSH terms

  • Exsanguination / etiology
  • Exsanguination / therapy*
  • Female
  • Fracture Fixation / methods*
  • Fractures, Bone / complications*
  • Fractures, Bone / surgery
  • Hemodynamics
  • Hemostatic Techniques*
  • Humans
  • Laparotomy / methods
  • Male
  • Pelvic Bones / injuries*
  • Pelvic Bones / surgery
  • Peritoneum / surgery
  • Treatment Outcome