SURGICAL-MANAGEMENT OF SEVERE PELVIC CRUSH TRAUMA

被引：0

作者：

PLATZ, A ^{[1
]}

FRIEDL, HP ^{[1
]}

KOHLER, A ^{[1
]}

TRENTZ, O ^{[1
]}

机构：

[1] UNIV HOSP ZURICH,UNFALLCHIRURG KLIN,DEPT CHIRURG,CH-8091 ZURICH,SWITZERLAND

来源：

HELVETICA CHIRURGICA ACTA | 1992年 / 58卷 / 06期

关键词：

D O I：

暂无

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Control of hemorrhage and prevention of septic complications are the predominant difficulties associated with severe pelvic crush injuries. According to our experience spontaneous tamponade, external compression (MAST/G-suits), and blind ligation of the hypogastric artery seem to be ineffective, whereas angiography followed by embolization, controlled ligation or vascular reconstruction, packing with scheduled 2nd look reexploration, and rigid fixation of the pelvic ring are recommended to control severe hemorrhage associated with these injuries. Moreover, early repair of bowel and urinary tract lesions, diverting colostomy with rectal wash-out, radical debridement, and open wound care of degloving avulsion injuries appear to be the most important procedures to prevent posttraumatic sepsis. Our pelvic crush trauma protocol is based on 84 consecutive cases treated between 1972 and 1990. In all cases the Injury Severity Score (ISS) was over 40 points, each patient required at least 10 units of whole blood or red cells, the overall mortality rate was 41 out of 84 patients.

引用

页码：925 / 929

页数：5