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Clinical Medicine Insights: Trauma and Intensive Medicine

The Role of Pelvic Packing for Hemodynamically Unstable Pelvic Ring Injuries

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Clinical Medicine Insights: Trauma and Intensive Medicine 2015:6 1-8

Review

Published on 26 Jan 2015

DOI: 10.4137/CMTIM.S12257


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Abstract

In patients with severe pelvic fractures, exsanguinating hemorrhage represents the major cause of death within the first 24 hours. Recently, multiple management algorithms have been proposed; however, the optimal treatment modalities, in particular, in the hemodynamically unstable patient with pelvic fracture are still a matter of debate. Mechanical pelvic stabilization by pelvic binder, anterior external fixator, and/or pelvic C-clamp constitutes the first treatment option in the hemodynamically unstable patient with pelvic fractures. The mechanically stabilized pelvic ring provides the basis for pelvic packing through a minimal extraperitoneal approach, which effectively controls venous bleeding and bleeding from the fractured bony surface. Patients with persistent hypotension and/or transfusion requirements should undergo angiography and selective embolization for definitive arterial control if necessary. This review article describes the current trend in the initial management of patients with pelvic fractures and hemodynamic instability, and focuses on the role of pelvic packing.



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As the Editor-in-Chief of Clinical Medicine Insights: Trauma and Intensive Medicine, I experience an outstanding professional and timely support by the publisher, Libertas Academica, in all editorial matters.
Dr Philip F. Stahel (Denver Health Medical Center, University of Colorado Denver, School of Medicine, Denver, CO, USA)
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