1Department of Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
2Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea
3Trauma Center, Wonju Severance Christian Hospital, Wonju, Korea
4Wonju Severance Pelvic Bone Research Group, Yonsei University Wonju College of Medicine, Wonju, Korea
5Department of Surgery, Trauma Center, National Health Insurance Service Ilsan Hospital, Goyang, Korea
Copyright © 2022 The Korean Society of Critical Care Medicine
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICT OF INTEREST No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS
Conceptualization: KMK, JYJ, KK. Data curation: JSC, JWK, MJK, YUC, HS, KK. Formal analysis: KMK, KK. Methodology: KMK, KK. Project administration: JSC, JWK, MJK, YUC, HS, JYJ, KSB, KK. Visualization: KMK, MJK, KK. Writing–original draft: KMK, MJK, KK. Writing–review & editing: all authors.
Values are presented as mean±standard deviation or number (%).
SSI: surgical site infection; SBP: systolic blood pressure; DM: diabetes mellitus; AIS: abbreviated injury scale; Hb: hemoglobin; WBC: white blood cell; DNI: delta neutrophil index; YB: Young-Burgess; LC: lateral compression; APC: anteroposterior compression; VS: vertical shear; REBOA: resuscitative endovascular balloon occlusion of the aorta; EF: external fixation; PPP: preperitoneal pelvic packing; SI: sacroiliac; ER: emergency room; pRBC: packed red blood cell.
Variable | No SSI (n=29) | SSI (n=15) | P-value |
---|---|---|---|
Median length of hospital stay (day) | 41 | 64 | 0.480 |
Median length of ICU stay (day) | 14 | 16 | 0.853 |
Mortality within 30 days, n (%) | 3 (10.3) | 3 (20.0) | 0.394 |
Variable | Time | No SSI (n=29) | SSI (n=15) | P-value |
---|---|---|---|---|
Time from PPP to tape removal (hr) | ≥48 | 12 (41.4) | 5 (33.3) | 0.603 |
Time from 2nd look surgery to drain removal (day) | ≥7 | 18 (62.1) | 8 (53.3) | 0.576 |
Variable | No SSI (n=29) | SSI (n=15) | P-value |
---|---|---|---|
Age (yr) | 59.2±13.5 | 55.2±18.3 | 0.655 |
Male | 17 (58.6) | 10 (66.7) | 0.603 |
Initial SBP (mm Hg) | 68.7±11.8 | 58.6±21.0 | 0.161 |
Cause of injury | 0.216 | ||
Traffic collision | 9 (31.0) | 2 (13.3) | |
Pedestrian struck | 9 (31.0) | 8 (53.3) | |
Fall | 10 (34.5) | 3 (20.0) | |
Other blunt trauma | 1 (3.4) | 1 (6.7) | |
Unknown | 0 | 1 (6.7) | |
DM | 5 (17.2) | 3 (20.0) | 1.000 |
Use of anticoagulants | 2 (6.9) | 2 (13.3) | 0.596 |
Associated injury (AIS ≥2) | 26 (89.7) | 14 (93.3) | 1.000 |
Concomitant bladder-urethra injury | 1 (3.4) | 4 (26.7) | 0.039 |
Concomitant bowel injury | 1 (3.4) | 2 (13.3) | 0.540 |
Injury severity score | 37.7±8.8 | 37.1±6.6 | 0.891 |
Initial Hb (g/dl) | 9.3±2.0 | 10.5±2.0 | 0.063 |
Initial lactate (mmol/L) | 5.2±2.8 | 7.6±4.3 | 0.055 |
Initial WBC (×109/L) | 14,207±4,874 | 13,414±5,304 | 0.561 |
Initial DNI (%) | 2.0±2.6 | 1.6±2.4 | 0.735 |
YB classification | 0.229 | ||
LC | 19 (65.5) | 7 (46.7) | |
APC | 2 (6.9) | 4 (26.7) | |
VS | 8 (27.6) | 4 (26.7) | |
Tile classification | 0.431 | ||
A | 0 | 0 | |
B | 19 (65.5) | 8 (53.3) | |
C | 10 (34.5) | 7 (46.7) | |
Open fracture | 1 (3.4) | 1 (6.7) | 1.000 |
Pelvic binder | 12 (41.4) | 10 (66.7) | 0.112 |
REBOA | 0 | 2 (13.3) | 0.111 |
EF during PPP | 4 (13.8) | 4 (26.7) | 0.414 |
SI joint screwing during PPP | 4 (13.8) | 2 (13.3) | 1.000 |
PPP in ER | 1 (3.4) | 3 (20.0) | 0.107 |
Median time required to perform PPP (min) | 35 | 25 | 0.333 |
Use of hemostatic gauze | 12 (41.4) | 5 (33.3) | 0.603 |
Median time from accident to PPP (min) | 275 | 190 | 0.122 |
Median time from PPP to tape removal (hr) | 45 | 41.3 | 0.428 |
Median time from 2nd look surgery to drain removal (day) | 9 | 11 | 0.682 |
Repacking during 2nd look surgery | 0 | 4 (26.7) | 0.010 |
Angioembolization after PPP | 2 (6.9) | 3 (20.0) | 0.319 |
Combined abdominal surgery | 5 (17.2) | 3 (20.0) | 1.000 |
pRBC transfusion during first 4 hours | 8.5±4.7 | 8.5±8.0 | 0.417 |
Variable | No SSI (n=29) | SSI (n=15) | P-value |
---|---|---|---|
Median length of hospital stay (day) | 41 | 64 | 0.480 |
Median length of ICU stay (day) | 14 | 16 | 0.853 |
Mortality within 30 days, n (%) | 3 (10.3) | 3 (20.0) | 0.394 |
Variable | Time | No SSI (n=29) | SSI (n=15) | P-value |
---|---|---|---|---|
Time from PPP to tape removal (hr) | ≥48 | 12 (41.4) | 5 (33.3) | 0.603 |
Time from 2nd look surgery to drain removal (day) | ≥7 | 18 (62.1) | 8 (53.3) | 0.576 |
No | Source of culture | Time of detection of SSI from the time of PPP (day) | Organism isolated |
---|---|---|---|
1 | Wound | 13 | Staphylococcus epidermidis, Acinetobacter baumannii |
2 | Wound | 12 | Staphylococcus aureus, Enterobacter aerogenes |
3 | Drain fluid | 6 | Enterococcus faecalis |
4 | Wound | 8 | Enterococcus casseliflavus |
5 | Drain fluid | 3 | Enterococcus faecium |
Klebsiella pneumoniae | |||
6 | Wound | 6 | Escherichia coli |
7 | Wound | 3 | S. epidermidis |
8 | Drain fluid | 3 | S. epidermidis |
9 | Wound | 9 | Methicillin-resistant Staphylococcus aureus |
Micrococcus kristinae | |||
A. baumannii | |||
10 | Wound | 12 | S. epidermidis |
E. faecium | |||
11 | Drain fluid, Wound | 9 | Corynebacterium striatum |
12 | Drain fluid | 13 | A. baumannii |
13 | Wound | 6 | Pus discharged |
No result of culture | |||
14 | Drain fluid | 14 | C. striatum |
15 | Wound | 5 | S. epidermidis |
Staphylococcus lugdunensis |
Values are presented as mean±standard deviation or number (%). SSI: surgical site infection; SBP: systolic blood pressure; DM: diabetes mellitus; AIS: abbreviated injury scale; Hb: hemoglobin; WBC: white blood cell; DNI: delta neutrophil index; YB: Young-Burgess; LC: lateral compression; APC: anteroposterior compression; VS: vertical shear; REBOA: resuscitative endovascular balloon occlusion of the aorta; EF: external fixation; PPP: preperitoneal pelvic packing; SI: sacroiliac; ER: emergency room; pRBC: packed red blood cell.
SSI: surgical site infection; ICU: intensive care unit.
Values are presented as number (%). SSI: surgical site infection; PPP: preperitoneal pelvic packing.
SSI: surgical site infection; PPP: preperitoneal pelvic packing.