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Journal of Trauma and Injury 2014;27(2):29-32.
Retroperitoneal Gauze Packing with Vacuum-Associated Closure for Pelvic Fracture with Hemodynamic Instability
Sung Jeep Kim, Ji Hoon T Kim
Department of Trauma Surgery, Uijeongbu St. Mary's Hospital, Catholic Medical University of Korea, Uijeonbu, Korea. surgeonkjh@gmail.com
혈역학적으로 불안정한 골반 골절에서 진공 폐쇄 드레싱을 병용한 후복막 거즈 충전법 치료
김성집, 김지훈
가톨릭대학교 의정부성모병원 외상외과
Received: 24 December 2013   • Revised: 12 April 2014   • Accepted: 10 June 2014
Abstract
Pelvic bone fracture with hemodynamic instability is fatal and the mortality rate can range up to 40%. Despite the big advances in the treatment of massive bleeding and hemorrhagic shock, the mortality associated with hemodynamically unstable pelvic bone fractures remains high. The gold standard of treatment for pelvic bone fracture with hemodynamic instability has not yet been determined and is an issue of main discussion among many doctors. Retroperitoneal packing is not yet wide spread in Korea, but is a good modality for managing of massive bleeding from pelvic bone fractures when an angiography suite or an expert surgeon is not available. A vacuum-assisted closure (VAC) system can also be applied with retroperitoneal packing in the manner of damage control surgery and open abdomen surgery. We present the case of a 51-year-old male who had a pelvic bone fracture with massive bleeding. We performed retroperitoneal gauze packing with a VAC system for the first time. The postoperative vital signs of patient were immediately stable, the massive bleeding was easily and quickly controlled, and the amount of transfusion of blood components was reduced.
Key Words: Pelvis; Fracture; Retroperitoneal; Packing; Vacuum
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