A treatment protocol for abdomino-pelvic injuries
Alberto Nicodemo1, Daniela Decaroli, Jacopo Pallavicini
1Orthopaedic Department, San Giovanni Bosco Hospital of Turin, Turin, Italy.
Summary
This study presents a new protocol for treating abdomino-pelvic injuries, prioritizing rapid pelvic stabilization in unstable patients. Preliminary results suggest this approach may reduce mortality and long-term complications from these severe injuries.
Area of Science:
- Trauma Surgery
- Emergency Medicine
- Orthopedic Surgery
Background:
- Abdomino-pelvic injuries pose significant challenges in emergency departments.
- Optimal treatment protocols for these injuries remain a subject of debate.
- This paper details a specific protocol implemented since 2002.
Purpose of the Study:
- To describe and evaluate a novel protocol for managing abdomino-pelvic injuries.
- To compare the protocol's effectiveness against existing treatment strategies.
- To assess the protocol's impact on patient outcomes and complication rates.
Main Methods:
- The protocol prioritizes rapid pelvic external fixation for hemodynamically unstable patients with pelvic ring lesions.
- Delayed imaging (e.g., CT scan) is employed as a second-line diagnostic tool.
- Pelvic stabilization precedes abdominal exploration in cases with positive FAST scans and abdominal injury.
Main Results:
- The study included 58 patients with unstable pelvic lesions; the mean Injury Severity Score was 27.2.
- Mortality was 8% (5 patients), primarily from hemorrhagic shock and pulmonary embolism.
- Complications included neurological deficits (12.3%), sexual dysfunction (20.7%), and fracture healing issues (3.4%).
Conclusions:
- Preliminary data suggest the protocol is comparable or superior to existing methods.
- The protocol may potentially decrease mortality and long-term sequelae of abdomino-pelvic trauma.
- Further validation with larger patient cohorts is recommended.
