Prevention of septic complications in massive pelvic-perineal injuries. Case reports

If they do not immediately lead to death, severe injuries of the pelvis and perineum are frequently complicated by serious invasive infection. This results in a considerable number of late deaths. Adherence to a strict treatment protocol aimed at the prevention of septic complications has undoubtedly reduced the mortality rate related to these injuries. The different aspects of our treatment protocol are outlined, and comprise: (i) antibiotic prophylaxis; (ii) assessment under general anaesthesia; (iii) radical surgical debridement; (iv) diversion of the faecal stream; (v) conservative management of urethral injuries; and (vi)frequent revision of the wounds at 24 - 48-hour intervals. Eight consecutive patients in whom septic complications were successfully prevented are reported on.