Selective Fecal Diversion in Complex Open Pelvic Fractures From Blunt Trauma

1994/09/01 by Paul D. Faringer · 17 citations
Medicine · #Pelvic and Acetabular Injuries #Abdominal Trauma and Injuries #Trauma and Emergency Care Studies

paper · doi:10.1001/archsurg.1994.01420330072014

Abstract

OBJECTIVE: To review the outcomes of patients with open pelvic fractures. DESIGN: Retrospective review of medical records. SETTING: Patients admitted from the injury scene or transferred within 24 hours to a level 1 trauma center. PATIENTS: Thirty-three patients sustaining blunt trauma had pelvic fractures and adjacent wounding. INTERVENTIONS: Treatment protocol that included selective fecal diversion, measures to arrest hemorrhage and prevent wound sepsis, manage associated pelvic injuries, and provide optimal orthopedic outcomes. MAIN OUTCOME MEASURES: Death and sepsis. RESULTS: Exsanguination occurred in one patient and death owing to head injuries occurred in five patients. Wound sepsis occurred in 31% of patients with colostomy and 19% without colostomy. CONCLUSIONS: Management of open pelvic fractures requires a well-coordinated group using several techniques. Selected patients with open pelvic fractures do not require fecal diversion. Incisions for orthopedic surgery should be considered when decisions are made regarding fecal diversion.

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• Open pelvic fracture: the killing fracture? [europepmc]
• Current outcomes of blunt open pelvic fractures: how modern advances in trauma care may decrease mortality. [europepmc]
• Chinese expert consensus on echelons treatment of pelvic fractures in modern war. [europepmc]
• Regional Injury Classification and Treatment of Open Pelvic Fractures. [europepmc]
• High incidence of surgical site infection may be related to suboptimal case selection for non-selective arterial embolization during resuscitation of patients with pelvic fractures: a retrospective study. [europepmc]
• Predictors of Acute Mortality After Open Pelvic Fracture: Experience From 37 Patients From A Level I Trauma Center. [europepmc]
• A New Understanding of the Mechanism of Injury to the Pelvis and Lower Limbs in Blast. [europepmc]
• The Road to Survival for Haemodynamically Unstable Patients With Open Pelvic Fractures. [europepmc]
• Postoperative Reduction Quality May Be the Most Important Factor That Causes Worse Functional Outcomes in Open and Closed Pelvic Fractures. [europepmc]
• Three-year functional outcome after open pelvic fracture treatment: a retrospective case series from a level I trauma center. [europepmc]
• Management of Open Tile C Pelvic Fractures and Their Outcomes: A Retrospective Study of 30 Cases. [europepmc]
• Morel-Lavallee lesions and number of surgeries for associated injuries predict surgical site infection risk following pelvic ring injury osteosynthesis. [europepmc]
• Emergency treatment of pelvic ring injuries: state of the art. [europepmc]
• Comparison of mortality between open and closed pelvic bone fractures in Korea using 1:2 propensity score matching: a single-center retrospective study. [europepmc]
• Polymicrobial infection presenting as non-clostridial gas gangrene in a patient with an open pelvic ring fracture accompanied by abdominal evisceration: a case report. [europepmc]

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