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Pre-peritoneal pelvic packing for the management of life-threatening pelvic fractures

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BackgroundPre-peritoneal pelvic packing (PPP) is a technique used for treating pelvic hemorrhage in patients with pelvic fractures and hemodynamic instability after a high-energy trauma representing a life-threatening situation. The aim… Click to show full abstract

BackgroundPre-peritoneal pelvic packing (PPP) is a technique used for treating pelvic hemorrhage in patients with pelvic fractures and hemodynamic instability after a high-energy trauma representing a life-threatening situation. The aim of this study was to perform a comprehensive review of the literature.MethodsA review of the medical literature was performed, based on the following inclusion criteria: patients sustaining pelvic fractures with hemodynamic instability and the inclusion of PPP as a tool for hemorrhage control. Articles not involving human patients, review articles, surveys, pediatric patients, hemodynamic stability, case reports, and not directly related publications; such as angiography with or without embolization, and REBOA use for hemorrhage control as a primary outcome evaluation were excluded from this search.ResultsEleven articles out of seventy-seven identified publications between 2008 and 2018 met the inclusion criteria and were included in this review.ConclusionsPPP is a surgical approach used in life-threatening situations due to pelvic fracture with high risk of death for exsanguination. Performed expediently, good results can be obtained with a decrease in the need for blood products, improved systolic blood pressure, and a decrease in mortality rates overall. This makes PPP an important life-saving tool.

Keywords: pre peritoneal; life; life threatening; peritoneal pelvic; pelvic fractures; pelvic packing

Journal Title: European Journal of Trauma and Emergency Surgery
Year Published: 2018

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