Pressure characteristics of pelvic binders

Jowett, Andrew J. L.; Bowyer, Gavin

doi:10.1016/j.injury.2006.03.018

Cited by 67 publications

(37 citation statements)

References 4 publications

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“…Most, but not all, orthopaedic registrars (79.1 %) stated that they would place the binder at the level of the GT. These results show that more adequate training is required, as there is clear evidence that compression around the GT is most effective in reducing unstable open-book fractures [8,16,17]. Importantly, a misplaced binder may make a pelvic injury worse if there is a fracture through the iliac crests.…”

Section: Discussionmentioning

confidence: 93%

A national survey of United Kingdom trauma units on the use of pelvic binders

Jain

Bleibleh

Marciniak

et al. 2013

International Orthopaedics (SICOT)

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Purpose Major pelvic injuries resulting from high-energy trauma require emergency hospital treatment, and part of the initial management includes mechanical stabilisation of the pelvis. Controversies include binder position, use in lateral compression injuries and application during radiological assessment. We present the results of a survey of both emergency department and orthopaedic specialties. Methods A telephone survey of all 144 trauma units in the UK accepting adult pelvic trauma patients was carried out in July 2012. The duty registrar for the emergency and orthopaedic departments was contacted and asked to complete a questionnaire. Results A response rate of 100 % was achieved. Pelvic binders were available for use in approximately three quarters of the trauma units surveyed. Eight-five emergency department (59 %) and 79 orthopaedic (54.9 %) registrars had been given training on pelvic binder application. Fiftysix emergency department (38.9 %) and 114 orthopaedic (79.1 %) registrars identified the level of the greater trochanters as the most suitable position for the binder. Forty-five emergency department (31.3 %) and 58 orthopaedic (40.3 %) registrars used pelvic binders in suspected lateral compression injuries. One hundred and twenty-six emergency department (87.5 %) and 113 orthopaedic (78.5 %) registrars would not release the binder during radiological assessment of the pelvis in a haemodynamically stable patient.

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Section: Discussionmentioning

confidence: 93%

A national survey of United Kingdom trauma units on the use of pelvic binders

Jain

Bleibleh

Marciniak

et al. 2013

International Orthopaedics (SICOT)

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“…≥ 9.3 kPa. This condition can lead to tissue damage after a prolonged period when pressure on the tissue interfaces is not controlled [4,6,8]. Hence, to prevent tissue damage there must be a cushion between the pelvic binder and human tissue to reduce the effects of tissue reaction from the prehospital device.…”

Section: Materials Model Validation Of Human Tissuementioning

confidence: 99%

“…To avoid tissue damage, the pressure recommended on tissue interfaces is kept below 9.3 kPa for more than 2-3 hours, continuously [5]. In the experiment, testing pressure measurements on the interaction between tissue and pelvic binder were performed by researchers to determine the influence of PCCDs on patients [3,4,[6][7][8]. All of these studies showed that the pressure on tissue interfaces exceeded the recommended pressure i.e.…”

Section: Introductionmentioning

confidence: 99%

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Pressure sores of human tissue damage during pelvic binder compression

Munandar

Huzni

Ismail

et al. 2022

Int. J. Automot. Mech. Eng.

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Pelvic circumferential compression is a device used to reduce injury which inadvertently, cause soft tissue damage. When force is applied excessively to the pelvic binder, tissue is damaged due to prolonged high pressure. Therefore, effect from this interaction between tissue and pelvic binder is an important factor to avoid pressure sores due to human tissue damage. The aim of this study is to investigate the effects of human tissue interaction due to compression of the pelvic binder using a finite element modelling approach. A three-dimensional human pelvic model was developed to simulate pressure distribution on tissue interfaces. The applied loads with two different conditions -dry and wet skin were applied on both tips of the pelvic strap during binder-tissue interaction. The compression load of the pelvic binder was estimated on a pelvic strap in order to reduce pelvic fracture. The compression load was varied substantially between locations as well as between skin conditions. There were two straps on the pelvis. For pelvic strap 1, the pressure on the sacrum and ilium was higher than the pressure measured on pelvic strap 2 while pressure on the anterior area was the same for both pelvic straps. Analysis results showed that the pressure which developed between both tissue and pelvic binder exceeded the recommended pressure i.e. ≥ 9.3 kPa at tissue interfaces. When pressure on tissue interfaces is not controlled, this condition can lead to tissue damage due to prolonged periods of time. Hence, to avoid tissue damage to the pelvic binder a cushion must be introduced to reduce the effect of tissue reaction from the prehospital device. Subsequently, tissue and pelvic binder interaction simulation results were compared with experimental data for validation in the model developed.

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“…Tissue damage, sufficient to cause pressure sores and skin necrosis, is believed to occur when a contact pressure above 9.3 kPa is sustained continuously for more than 2-3 h (29). This threshold was found to be exceeded at the binder-skin interface at the anterior superior iliac spine, greater trochanters, and sacrum in a study on 10 healthy individuals (30). The polytraumatized patient is likely to be at increased risk of soft-tissue damage due to systemic factors promoting tissue breakdown (31).…”

Section: Identifying Pelvic Hemorrhagementioning

confidence: 99%

Management of Bleeding Pelvic Fractures

Marzi

Lustenberger

2014

Scand J Surg

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Introduction: in patients with severe pelvic fractures, exsanguinating hemorrhage represents the major cause of death within the first 24 h. despite advances in management, the mortality rate in these patients remains significantly high. recently, multiple treatment algorithms have been proposed for patients with severe pelvic fractures; however, the optimal modalities in particular in the hemodynamically unstable patient are still a matter of lively debate.this review article focuses on the recent body of knowledge on the different treatment options in patients with severe pelvic fractures and proposes the possible role of each modality in the management of these patients.Methods: the Medline database was searched for medical literature addressing the management of severe pelvic fractures with specific attention given to recent, clinically relevant publications.Results: angiography and embolization have emerged as excellent methods for addressing arterial bleeding. Mechanical pelvic stabilization and surgical hemostasis by pelvic packing, on the other hand, may effectively control venous bleeding and bleeding from the fractured bony surface. However, since there is no precise way to determine the major source of bleeding that is responsible for the hemodynamic instability, controversy remains over the timing and optimal order of angiography, mechanical pelvic stabilization, and packing.Conclusions: the author's own approach to these patients includes angiographic embolization as a first-line treatment only in hemodynamically stable patients with an arterial blush seen in the computed tomography scan, indicating acute arterial bleeding. Hemodynamically unstable patients are immediately transferred to the operating room, where pelvic packing and mechanical stabilization of the pelvic ring are carried out. optionally, a subsequent postoperative angio-embolization is performed if signs of further bleeding remain present.

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Pressure characteristics of pelvic binders

Cited by 67 publications

References 4 publications

A national survey of United Kingdom trauma units on the use of pelvic binders

A national survey of United Kingdom trauma units on the use of pelvic binders

Pressure sores of human tissue damage during pelvic binder compression

Management of Bleeding Pelvic Fractures

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