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1 "Myoung Jun Kim"
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Original Article
Trauma
Determination of risk factors associated with surgical site infection in patients undergoing preperitoneal pelvic packing for unstable pelvic fracture
Kang Min Kim, Myoung Jun Kim, Jae Sik Chung, Ji Wool Ko, Young Un Choi, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Kwangmin Kim
Acute Crit Care. 2022;37(2):247-255.   Published online April 22, 2022
DOI: https://doi.org/10.4266/acc.2021.01396
  • 3,723 View
  • 214 Download
  • 5 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Background
Several recent studies have shown that preperitoneal pelvic packing (PPP) effectively produces hemostasis in patients with unstable pelvic fractures. However, few studies have examined the rate of surgical site infections (SSIs) in patients undergoing PPP following an unstable pelvic fracture. The purpose of the present study was to evaluate factors associated with SSI in such patients.
Methods
We retrospectively reviewed the medical charts of 188 patients who developed hemorrhagic shock due to pelvic fracture between April 2012 and May 2021. Forty-four patients were enrolled in this study.
Results
SSI occurred in 15 of 44 patients (34.1%). The SSIs occurred more frequently in cases of repacking during the second-look surgery (0 vs. 4 [26.7%], P=0.010) and combined bladder-urethra injury (1 [3.4%] vs. 4 [26.7%], P=0.039). The incidence of SSIs was not significantly different between patients undergoing depacking within or after 48 hours (12 [41.4%] vs. 5 [33.3%], P=0.603). The mean time to diagnosis of SSI was 8.1±3.9 days from PPP. The most isolated organism was Staphylococcus epidermidis.
Conclusions
Repacking and combined bladder-urethra injury are potential risk factors for SSI in patients with unstable pelvic fracture. Close observation is recommended for up to 8 days in patients with these risk factors. Further, 48 hours after PPP, removing the packed gauze on cessation of bleeding and not performing repacking can help prevent SSI. Additional analyses are necessary with a larger number of patients with the potential risk factors identified in this study.

Citations

Citations to this article as recorded by  
  • Angioembolization Has Similar Efficacy and Lower Total Charges than Preperitoneal Pelvic Packing in Patients With Pelvic Ring or Acetabulum Fractures
    Aaron Singh, Travis Kotzur, Ezekial Koslosky, Rishi Gonuguntla, Lorenzo Canseco, David Momtaz, Ali Seifi, Case Martin
    Journal of Orthopaedic Trauma.2024; 38(5): 254.     CrossRef
  • Factors Associated With Pelvic Infection After Pre-Peritoneal Pelvic Packing for Hemodynamically Unstable Pelvic Fractures
    Jennifer E. Baker, Husayn A. Ladhani, Caitlyn McCall, Chelsea R. Horwood, Nicole L. Werner, Barry Platnick, Clay Cothren Burlew
    Surgical Infections.2024; 25(5): 399.     CrossRef
  • Comparison of Conventional versus Modified Preperitoneal Pelvic Packing in Patients with Bleeding Pelvic Fractures: A Single-Center Retrospective Pilot Study
    Sebeom Jeon, Byungchul Yu, Gil Jae Lee, Min A Lee, Jungnam Lee, Kang Kook Choi
    Journal of Clinical Medicine.2024; 13(14): 4062.     CrossRef
  • Current Management of Hemodynamically Unstable Patients with Pelvic Fracture
    Kevin Harrell, Chelsea Horwood, Clay Cothren Burlew
    Current Surgery Reports.2023; 11(4): 92.     CrossRef
  • Open Fixation After Preperitoneal Pelvic Packing Is Associated With a High Surgical Site Infection Rate
    Ye Joon Kim, Bryan L. Scott, Fredric M. Pieracci, Ernest E. Moore, Cyril Mauffrey, Joshua A. Parry
    Journal of Orthopaedic Trauma.2023; 37(11): 547.     CrossRef
  • Extraperitoneal pelvic packing in trauma – a review
    Sajad Ahmad Salati
    Polish Journal of Surgery.2022; 95(3): 46.     CrossRef

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