Treatment of open pelvic fractures with perineal laceration infection

Abstract

Objective To evaluate the effect of external fixator,colostomy,repeated debridement and vacuum-assisted closure (VAC) to treat open pelvic fractures concomitant with perineal laceration and infection.Methods A retrospective analysis was made about 8 cases of open pelvic fractures concomitant with perineal laceration and infection from February 2004 to January 2011.It includes 7 men and 1 woman,with the average age of 36.3 years (ranged from 22 to 59 years).Five cases were injured by traffic accident,2 cases were fall-down from height,and 1 case was crushed by weight.Fractures type according to Tile:3 cases were type B,5 cases were type C.All cases were type I according to Faringer classification.All patients were treated with external fixator according to the displacement of pelvic fractures,early colostomy,repeated debridement,and after infection be controlled,VAC was used to close wound and drainage.Results The eight cases of open pelvic fractures concomitant with perineal laceration and infection were followed up from 6 to 36 months,with the average of 16 months.The infection was healed in all patients,and the body temperature and blood routine got normal.The period from injury to wound closing was from 8 to 43 days,with the average time of 17 days.According to the Majeed evaluation system,the pelvic fractures healing was evaluated after treatment:2 cases were excellent; 3 cases were good; 2 cases were fair;,1 case was poor;,the good to excellent rate was 62.5％.Conclusion The method of applying external fixator,colostomy,repeated debridement and VAC to treat open pelvic fractures concomitant with perineal laceration and infection is useful.The methods played an active role in controlling infection,reducing infection rates and mortality rates,and shortening the healing time. Key words: Pelvis; Fractures, open; Pefineum; Lacerations