Application of pre-peritoneal packing in emergency hemostasis for hemodynamically unstable pelvic fracture: a review
10.3760/cma.j.cn501098-20240806-00473
- VernacularTitle:腹膜外填塞术在血流动力学不稳定型骨盆骨折急救止血中的应用研究进展
- Author:
Shenbo HUANG
1
;
Yue FANG
1
;
Shuai HE
1
;
Hanyu HUANG
1
Author Information
1. 四川大学华西医院骨科，创伤医学中心，成都 610041
- Publication Type:Journal Article
- Keywords:
Pelvis;
Fractures, bone;
Shock, traumatic;
Hemostasis;
Pre-peritoneal pelvic packing
- From:
Chinese Journal of Trauma
2025;41(1):111-116
- CountryChina
- Language:Chinese
-
Abstract:
Hemodynamically unstable pelvic fracture results from blunt external force and is often accompanied by hypotension. Massive blood transfusion is needed in the case and the mortality rate can be 40%-65%. The key to the early treatment of hemodynamically unstable pelvic fracture lies in bleeding control. Currently, the primary methods of hemostasis include pelvic brace fixation, pre-peritoneal pelvic packing, internal iliac artery ligation, internal iliac artery embolization, etc. However, due to the urgent need for emergency hemostasis and the difficulty in identifying the bleeding sites, hemodynamically unstable pelvic fracture remain a serious challenge for trauma surgeons. Pre-peritoneal pelvic packing used in emergency situations to control the bleeding hemodynamically unstable pelvic fracture can effectively control venous and fracture-site bleeding after pelvic fracture and reduce mortality. Moreover, it is easy and convenient to operate and is especially suitable for cases in which angiographic embolization can not be performed immediately or the patients are hemodynamically extremely unstable. However, there is still a controversy in the clinical practice regarding the selection between pre-peritoneal pelvic packing and other hemostatic methods such as angiographic embolization. To this end, the author reviewed the progress of the researches on the application of pre-peritoneal pelvic packing in emergency hemostasis for hemodynamically unstable pelvic fracture, aiming to provide a reference for its clinical treatment.
