Preperitoneal Packing

 

VBMC TRAUMA CARE SERVICES GUIDELINE

TITLE: Pre-peritoneal packing

PURPOSE: Operative management of pelvic bleeding

In the hemodynamically unstable patient with pelvic fractures, operative intervention maybe required to stabilize that patient whilst interventional radiology responds.

Recommendation for the patient to be taken to the OR emergently for pre-peritoneal packing.

Operative procedure as outlined:

https://youtu.be/RYHbEPE-Tno

If the patient is undergoing an exploratory laparotomy and significant pelvic bleeding/ hematoma is encountered and the patient is unstable, the pelvic hematoma should be opened and vascular control should be attempted. The pelvis should then be packed and the overlaying peritoneum sound be closed with a running suture.

If either scenario outlined above is encountered; Interventional radiology should be notified as an emergent consult. Once the patient has been stabilized from an operative standpoint they should be transferred directly to Interventional radiology for embolization.