Experience of application of extraperitoneal pelvic packing in unstable pelvic ring injuries
https://doi.org/10.24884/0042-4625-2017-176-4-44-47
Abstract
OBJECTIVE. Clinical efficacy of extraperitoneal pelvic packing for hemostasis was assessed in patients with unstable pelvic ring injuries and signs of unstable hemodynamics. MATERIAL AND METHODS. The results of treatment were analyzed in 19 patients with hemodynamically unstable pelvic ring injuries. Extraperitoneal pelvic packing was applied in order to stop bleeding after mechanical pelvic stabilization. The evaluation of hemostasis efficacy was performed by using computerized helical tomography with intravenous contrast. RESULTS. The extraperitoneal pelvic packing allowed doctors to achieve stop of bleeding in 14 (73,7 %) patients. CONCLUSIONS. Complex of mechanical stabilization and extraperitoneal pelvic packing of damaged pelvic ring could be actively used in cases of severe injuries for victims in critical conditions.
About the Authors
I. M. Samokhvalov
S. M. Kirov Military Medical Academy
Russian Federation
Russian Federation
I. V. Kazhanov
S. M. Kirov Military Medical Academy
Russian Federation
Russian Federation
V. A. Manukovskiy
I. I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine
Russian Federation
Russian Federation
A. N. Tulupov
I. I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine
Russian Federation
Russian Federation
S. I. Mikityuk
S. M. Kirov Military Medical Academy
Russian Federation
Russian Federation
Ya. V. Gavrishchuk
I. I. Dzhanelidze St. Petersburg Research Institute of Emergency Medicine
Russian Federation
Russian Federation
References
1. Анкин Л. Н., Пипия Г. Г., Анкин Н. Л. Лечение повреждений таза у пострадавших с изолированной и сочетанной травмой // Вестн. травматол. и ортоп. 2007. № 3. С. 32-35.
2. Самохвалов И. М., Борисов М. Б., Кажанов И. В., Денисенко В. В., Микитюк С. И., Гребнев А. Р., Рева В. А. Особенности первого этапа тактики многоэтапного хирургического лечения (Damage control) при нестабильных переломах таза // Скорая мед. помощь. 2016. № 3. С. 39-45.
3. Тюрин М. В., Кажанов И. В., Мануковский В. А., Ганин В. Н., Денисов А. В. Обоснование хирургической тактики в остром периоде травматической болезни при нестабильных травмах таза // Вестн. нац. медико-хир. центра им. Н. И. Пирогова. 2012. № 3. С. 21-31.
4. Burlew C. C., Moore E. E., Smith W. R. et al. Preperitoneal pelvic packing / external fixation with secondary angioembolization: optimal care for life-threatening hemorrhage from unstable pelvic fractures // J. Amer. Coll. Surg. 2011. Vol. 212, № 4. P. 628-635.
5. Chiara O., Fratta E., Mariani A. et al. Efficacy of extra-peritoneal pelvic packing in hemodynamically unstable pelvic fractures, a Propensity Score Analysis World // J. Emerg. Surg. 2016. Vol. 11. P. 22.
6. Cothren C. C., Osborn P. M., Moore E. E. et al. Preperitonal pelvic packing for hemodynamically unstable pelvic fractures : a paradigm shift // J. Trauma. 2007. Vol. 62, № 4. P. 839-842.
7. Jang J. Y., Shim H., Jung P.Y. et al. Preperitoneal pelvic packing in patients with hemodynamic instability due to severe pelvic fracture : early experience in a Korean trauma center // Scand. J. of Trauma, Resuscitation and Emergency Med. 2016. Vol. 24. P. 3.
8. Tai D. K., Li W.H., Lee K. Y. et al. Retroperitoneal pelvic packing in the management of hemodynamically unstable pelvic fractures : a level I trauma center experience // J. Trauma. 2011. Vol. 71, № 4. P. Е79-Е86.
9. Thorson C. M., Ryan M. L., Otero C. A. et al. Operating room or angiography suite for hemodynamically unstable pelvic fractures? // J. Trauma. 2012. Vol. 72, № 2. P. 364-372.
Review
For citations:
Samokhvalov I.M., Kazhanov I.V., Manukovskiy V.A., Tulupov A.N., Mikityuk S.I., Gavrishchuk Ya.V. Experience of application of extraperitoneal pelvic packing in unstable pelvic ring injuries. Grekov's Bulletin of Surgery. 2017;176(4):44-47. (In Russ.) https://doi.org/10.24884/0042-4625-2017-176-4-44-47
Views:
683
Email this article 