4 Principles of Pelvic Damage control

Pelvic damage control is an approach for stabilizing pelvic injuries, in order to improve the overall physiology of a patient.

Since, pelvic fractures cause maximum of blood loss in a patient, it is necessary to prevent complications in a primary setting.

Here, we outline the four different principles of pelvic damage control

1. Close reduction of pelvis at admission
2. Application of external fixation
3. Control of hemorrhage
4. Control of contamination

Close reduction of pelvis at admission

This is necessary for dislocations and fracture-dislocations. Close reduction is fruitful under fluoroscopic guidance.

Application of external fixation

External fixation is a must to reduce blood loss, align fracture fragments, and reduce morbidity.

There are four techniques of external fixation like:

1. Wrapping pelvis with sheets with internal rotation and slight flexion
2. Conventional external fixator
3. Pelvis C-Clamp
4. Pneumatic anti-shock garment

Pelvic Damage Control: Control of hemorrhage

Since, pelvic fractures are the most bleeding fractures, our aim must be to reduce and control any sources of hemorrhage.

We can use pelvic packing in cases of open injuries or use angiography alternatively for this purpose.

Control of contamination

Control of contamination is must for a infection-free good outcome in pelvic injuries.

One can achieve this step by repairing genitourinary and rectal injuries. Additionally, debridement of necrotic tissue can also help in improving outcome.

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