Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen
Purpose Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. T...
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Korean Society of Traumatology
2020-03-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://www.jtraumainj.org/upload/pdf/jti-2019-044.pdf |
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| author | Kyunghak Choi Kwang-Hwan Jung Min Ae Keum Sungjeep Kim Jihoon T Kim Kyu-Hyouck Kyoung |
| author_facet | Kyunghak Choi Kwang-Hwan Jung Min Ae Keum Sungjeep Kim Jihoon T Kim Kyu-Hyouck Kyoung |
| author_sort | Kyunghak Choi |
| collection | DOAJ |
| description | Purpose Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44–198), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination. |
| format | Article |
| id | doaj-art-27413b25d6c04c11a6ca3ef106038c19 |
| institution | OA Journals |
| issn | 1738-8767 2287-1683 |
| language | English |
| publishDate | 2020-03-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-27413b25d6c04c11a6ca3ef106038c192025-08-20T02:01:30ZengKorean Society of TraumatologyJournal of Trauma and Injury1738-87672287-16832020-03-01331182210.20408/jti.2019.0441004Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open AbdomenKyunghak Choi0Kwang-Hwan Jung1Min Ae Keum2Sungjeep Kim3Jihoon T Kim4Kyu-Hyouck Kyoung5 Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Orthopedic Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, KoreaPurpose Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44–198), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.http://www.jtraumainj.org/upload/pdf/jti-2019-044.pdfabdominal injurieslaparotomypelvic bonesfracture fixationinfections |
| spellingShingle | Kyunghak Choi Kwang-Hwan Jung Min Ae Keum Sungjeep Kim Jihoon T Kim Kyu-Hyouck Kyoung Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen Journal of Trauma and Injury abdominal injuries laparotomy pelvic bones fracture fixation infections |
| title | Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen |
| title_full | Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen |
| title_fullStr | Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen |
| title_full_unstemmed | Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen |
| title_short | Feasibility of Early Definitive Internal Fixation of Pelvic Bone Fractures in Therapeutic Open Abdomen |
| title_sort | feasibility of early definitive internal fixation of pelvic bone fractures in therapeutic open abdomen |
| topic | abdominal injuries laparotomy pelvic bones fracture fixation infections |
| url | http://www.jtraumainj.org/upload/pdf/jti-2019-044.pdf |
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