Control of Severe Hemorrhage Using C-Clamp and Pelvic Packing in Multiply Injured Patients With Pelvic Ring Disruption

Ertel, Wolfgang; Keel, Marius; Eid, Karim; Platz, Andreas; Trentz, O.

doi:10.1097/00005131-200109000-00002

Cited by 267 publications

(110 citation statements)

References 25 publications

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“…Additionally, the ability to clear lactate to normal levels can be used to evaluate the effectiveness of resuscitation. We have previously reported that lactate levels correlate with the outcome of severely injured patients with pelvic fractures [48] and advocate to use this parameter for assessment of the patients hemodynamic state and to monitor success of shock treatment. Definitive "staged" surgical procedures The results of this study confirm previous investigations that rapid localization and control of the major source of hemorrhage is pivotal for survival of multiple injured patients with pelvic ring disruption.…”

Section: Discussionmentioning

confidence: 99%

Therapeutical Strategies and Outcome of Polytraumatized Patients with Pelvic Injuries A Six-Year Experience

Ertel¹,

Eid²,

Keel³

et al. 2000

Eur J Trauma

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Section: Discussionmentioning

confidence: 99%

Therapeutical Strategies and Outcome of Polytraumatized Patients with Pelvic Injuries A Six-Year Experience

Ertel¹,

Eid²,

Keel³

et al. 2000

Eur J Trauma

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“…Surgical packing of the small pelvis for the treatment of ongoing bleeding can only be successful when pelvic external fixation is carried out beforehand. External fixation and C-clamping create mechanical stability; the fixed bony structures form a resistance to which packing is effective [39]. Contrary to the pelvic binder and C-clamp, the external fixator can remain longer on the pelvic ring.…”

Section: External Fixationmentioning

confidence: 99%

Management of Acute Hemorrhage in Pelvic Trauma: An Overview

Rommens

Hofmann

Hessmann³

2010

Eur J Trauma

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Pelvic disruption is a combination of fractures or dislocations of the pelvic ring with trauma of the soft tissues on the inside and outside of this ring. Hemodynamic instability is the result of blood loss out of the fracture fragments, the posterior venous plexus, ruptured pelvic organs, or arterial lesions. In the resuscitation phase, different measures are possible to reduce the volume of the disrupted pelvis and to restore mechanical stability. They are not competitive but complementary. Pelvic binders should be used in the prehospital phase before and during transport. Application of a pelvic C-clamp is restricted to inhospital patients with C-type pelvic ring lesions and with severe and ongoing hemodynamic instability. External fixation is most useful in B-type but also has limited value in C-type injuries. The prerequisite for pelvic packing is the restoration of mechanical stability by pelvic C-clamping or external fixation. It is effective in severe venous bleeding in the small pelvis. Pelvic angiography and selective embolization is performed in patients with active arterial bleeding. These patients can be identified by a convincing clinical picture, by early multislice computed tomography (CT) with contrast- enhanced angiographic technique, or by the persistent need for volume replacement after C-clamping, external fixation, or pelvic packing.

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“…Die intensivierte Schocktherapie und ggf. Gerinnungssubstitution wird während der Notfallstabilisierung ununterbrochen weitergeführt [1,2,9,11,22,23] (. Abb.…”

Section: "Becken-notfall"unclassified

Stumpfe Beckenverletzung

Peña

Culemann

Burkhardt

et al. 2006

Chirurg

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Life-threatening complex pelvic fractures are commonly associated with vast peripelvine soft-tissue injuries and hemorrhage. Correct assessment and classification of the existing pelvic trauma and additional severe injuries present is required for accurate diagnosis and effective therapy. Treatment of the usually multiply injured patient is time-sensitive. The circulatory situation is the benchmark for diagnostic and therapeutic actions. Emergency stabilization of an initially unstable pelvic ring should be done first, followed by an extraperitoneal tamponade, if needed to control bleeding. The positive results of these actions can be measured by hemodynamic parameters. Delayed definitive internal stabilization of the anterior and/or posterior pelvic ring is then performed according to the fracture classification.

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Control of Severe Hemorrhage Using C-Clamp and Pelvic Packing in Multiply Injured Patients With Pelvic Ring Disruption

Cited by 267 publications

References 25 publications

Therapeutical Strategies and Outcome of Polytraumatized Patients with Pelvic Injuries A Six-Year Experience

Therapeutical Strategies and Outcome of Polytraumatized Patients with Pelvic Injuries A Six-Year Experience

Management of Acute Hemorrhage in Pelvic Trauma: An Overview

Stumpfe Beckenverletzung

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