Abstract
Background: Data on the efficacy and safety of non-invasive Pelvic Circumferential Compression Devices (PCCDs) is limited. Tissue damage may occur if a continuous pressure on the skin exceeding 9.3 kPa is sustained for more than two or three hours. The aim of this study was to gain insight into the pressure build-up at the interface, by measuring the PCCD-induced pressure when applying pulling forces to three different PCCDs (Pelvic Binder®, SAM-Sling® and T-POD®) in a simplified model. Methods: The resulting exerted pressures were measured at four ‘anatomical’ locations (right, left, posterior and anterior) in a model using a pressure measurement system consisting of pressure cuffs. Results: The exerted pressure varied substantially between the locations as well as between the PCCDs. Maximum pressures ranged from 18.9-23.3 kPa and from 19.2-27.5 kPa at the right location and left location, respectively. Pressures at the posterior location stayed below 18 kPa. At the anterior location pressures varied markedly between the different PCCDs. Conclusion: The circmferential compression by the different PCCDs showed high pressures measured at the four locations using a simplified model. Difference in design and functional characteristics of the PCCDs resulted in different pressure build-up at the four locations. When following the manufacturer’s instructions, the exerted pressure of all three PCCDs tested exceeded the tissue damaging level (9.3 kPa). In case of prolonged use in a clinical situation this might put patients at risk for developing tissue damage.
Highlights
Pelvic fractures are common injuries as a result of highenergy trauma
The measurements in this study provided insight into the pressure build-up by the three different Pelvic Circumferential Compression Devices (PCCDs) at the interface at four locations when using a novel simplified, artificial model of the human pelvis
The circumferential compression by the different PCCDs showed high pressures measured at the four locations using a simplified artificial model
Summary
Pelvic fractures are common injuries as a result of highenergy trauma. The incidence of these fractures is increasing [1]. Anatomic reduction and stabilization of pelvic fractures prevents blood loss by limiting bleeding from the fracture site and by reducing the pelvic volume. External stabilization of the pelvis should reduce transfusion requirements and length of hospital stay, and has shown to improve survival in patients with unstable pelvic fractures [3]. Advanced Trauma Life Support (ATLS) guidelines advise the use of a PCCD when an unstable pelvic fracture is suspected or diagnosed as a technique to stabilize the patient hemodynamically by reducing blood loss. Data on the efficacy and safety of non-invasive Pelvic Circumferential Compression Devices (PCCDs) is limited. The aim of this study was to gain insight into the pressure build-up at the interface, by measuring the PCCD-induced pressure when applying pulling forces to three different PCCDs (Pelvic Binder®, SAMSling® and T-POD®) in a simplified model
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