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预防大型开放性骨盆会阴损伤的骨盆脓毒症。

Prevention of pelvic sepsis in major open pelviperineal injury.

机构信息

Department of Surgery-Trauma Service, Princess Alexandra Hospital, 199 Ipswich Road, Woolloongabba, Brisbane, QLD 4012, Australia.

出版信息

Injury. 2012 Apr;43(4):533-6. doi: 10.1016/j.injury.2011.12.002. Epub 2012 Jan 4.

Abstract

Compound pelvic fractures are deemed to be one of the most severe orthopaedic injuries with an extremely high morbidity and mortality. After the initial resuscitation phase the prevention of pelvic sepsis is one of the main treatment goals for patients with an open pelvic fracture. If there is a suspicion of a rectal injury or if the wounds are in the perineal area, The Princess Alexandra Hospital's management plan includes early faecal diversion combined with vigorous soft tissue debridement, VAC(®) therapy and (if indicated) external fixation of the pelvic fracture. We present our flowchart for the treatment of trauma patients with compound pelvic fractures illustrated by a case report describing a 32 year old patient who sustained an open pelvic ring injury in a workplace accident. The aim of this paper is to underline the importance of a safe, straightforward approach to compound pelvic fractures.

摘要

复合性骨盆骨折被认为是最严重的骨科损伤之一,具有极高的发病率和死亡率。在初始复苏阶段后,预防骨盆感染是开放性骨盆骨折患者的主要治疗目标之一。如果怀疑有直肠损伤,或者伤口在会阴区域,Princess Alexandra 医院的管理方案包括早期粪便转流术,结合剧烈的软组织清创术、VAC(®)治疗和(如有指征)骨盆骨折外固定。我们通过一个病例报告介绍了一种治疗伴有复合性骨盆骨折的创伤患者的流程图,该病例报告描述了一位 32 岁的患者在工作场所事故中遭受开放性骨盆环损伤。本文的目的是强调安全、直接的方法治疗复合性骨盆骨折的重要性。

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