Management of hemodynamically unstable pelvic trauma: results of the first Italian consensus conference (cooperative guidelines of the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology -Section of Vascular and Interventional Radiology- and the World Society of Emergency Surgery)

World Journal of Emergency Surgery

Luca Ansaloni⁶  Gregorio Tugnoli¹  Valter Sonzogni^2,23  Luigi Rizzi^2,24  Gennaro Rispoli⁹  Sergio Ribaldi^1,10  Antonio Rampoldi^1,19  Eugenio Poletti⁶  Elia Poiasina⁶  Michele Pisano⁶  Gabriela Elisa Nita⁶  Raffaella Niola^1,13  Giuseppe Nardi⁵  Tiziana Mastropietro⁶  Alessandro Massè²  GianMariano Marchesi^1,16  Marco Lotti⁶  Michela Giulii Capponi⁶  Giorgio Gambale^2,20  Giovanni Faustinelli⁶  Andrea Fabbri^1,15  Giuseppe Dodi^2,21  Salomone Di Saverio^1,11  Salvatore De Masi⁷  Nicola Colaianni⁶  Osvaldo Chiara⁸  Fausto Catena^1,12  Claudio Carlo Castelli^2,24  Luca Campanati⁶  Stefania Camagni⁶  Walter Biffl⁴  Giorgio Berlot³  Alberto Belluati^1,14  Giovanni Bellanova^1,17  Marco Barozzi^1,18  Claudio Arici^1,18  Roberto Agazzi^2,22  Dario Piazzalunga⁶  Roberto Manfredi⁶  Federico Coccolini⁶  Stefano Magnone⁶ 

[1] Trauma Surgery, Ospedale Maggiore, Bologna, Italy;Orthopedics and Traumatology, Azienda Ospedaliera-Universitaria S. Luigi Gonzaga Orbassano - University of Torino, Torino, Italy;Intensive Care Unit, Ospedali Riuniti di Trieste, Trieste, Italy;Professor of Surgery University of Colorado, Denver Health Medical Center, Denver, USA;Shock and Trauma, Ospedale San Camillo – Forlanini Roma, Rome, Italy;First General Surgery Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy;Epidemiology, Ospedale Meyer, Florence, Italy;General Surgery-Trauma Team, Ospedale Niguarda Ca’ Granda, Milan, Italy;General Surgery, Azienda Sanitaria Locale Na1 Centro Presidio Ospedaliero Ascalesi, Naples, Italy;Compartimental Sindrome Unit, Policlinico Umberto I, Rome, Italy;Trauma Surgery and General and Emergency Surgery, Ospedale Maggiore, Bologna, Italy;Emergency Surgery, Azienda Ospedaliera Universitaria, Parma, Italy;Interventional Radiology, Ospedale Cardarelli, Naples, Italy;Orthopedics and Traumatology, Presidio Ospedaliero di Ravenna, Ravenna, Italy;Emergency Medicine, Ospedale Morgagni-Pierantoni, Forlì, Italy;Intensive Care Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy;Second General Surgery, Ospedale Santa Chiara, Trento, Italy;Emergency Medicine Unit, Ospedale Papa Giovanni XXIII, Bergamo, Italy;Interventional Radiology, Ospedale Niguarda Ca’ Granda, Milan, Italy;Intensive Care and Anesthesiology, Ospedale Morgagni-Pierantoni, Forlì, Italy;Clinica Chirurgia, University of Padova, Padova, Italy;Interventional Radiology, Ospedale Papa Giovanni XXIII, Bergamo, Italy;Anesthesiology Service, Ospedale Papa Giovanni XXIII, Bergamo, Italy;Orthopedics and Traumatology, Ospedale Papa Giovanni XXIII, Bergamo, Italy

关键词: Pelvic binder;    External fixation;    Preperitoneal pelvic packing;    Angiography;    Pelvic trauma;   

Others  :  791377
DOI  :  10.1186/1749-7922-9-18

 received in 2014-02-03, accepted in 2014-02-24,  发布年份 2014

【 摘 要 】

Hemodynamically Unstable Pelvic Trauma is a major problem in blunt traumatic injury. No cosensus has been reached in literature on the optimal treatment of this condition. We present the results of the First Italian Consensus Conference on Pelvic Trauma which took place in Bergamo on April 13 2013. An extensive review of the literature has been undertaken by the Organizing Committee (OC) and forwarded to the Scientific Committee (SC) and the Panel (JP). Members of them were appointed by surgery, critical care, radiology, emergency medicine and orthopedics Italian and International societies: the Italian Society of Surgery, the Italian Association of Hospital Surgeons, the Multi-specialist Italian Society of Young Surgeons, the Italian Society of Emergency Surgery and Trauma, the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care, the Italian Society of Orthopaedics and Traumatology, the Italian Society of Emergency Medicine, the Italian Society of Medical Radiology, Section of Vascular and Interventional Radiology and the World Society of Emergency Surgery. From November 2012 to January 2013 the SC undertook the critical revision and prepared the presentation to the audience and the Panel on the day of the Conference. Then 3 recommendations were presented according to the 3 submitted questions. The Panel voted the recommendations after discussion and amendments with the audience. Later on a email debate took place until December 2013 to reach a unanimous consent. We present results on the 3 following questions: which hemodynamically unstable patient needs an extraperitoneal pelvic packing? Which hemodynamically unstable patient needs an external fixation? Which hemodynamically unstable patient needs emergent angiography? No longer angiography is considered the first therapeutic maneuver in such a patient. Preperitoneal pelvic packing and external fixation, preceded by pelvic binder have a pivotal role in the management of these patients.

Hemodynamically Unstable Pelvic Trauma is a frequent death cause among people who sustain blunt trauma. We present the results of the First Italian Consensus Conference.

【 授权许可】

   
2014 Magnone et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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