A clinical assessment of preperitoneal packing adequacy for pelvic fracture bleeding control.

Background: This study aimed to objectively assess the laparotomy pads to potential hemorrhage sites proximity in pelvic fracture patients who underwent post-pre peritoneal packing (PPP) CT scans with packs in situ.

Methods: The CT scans of 19 patients were assessed to measure the distance between laparotomy pads and predetermined pelvic anatomical landmarks.

Results: A total of 38 measurements showed that the median pack-to-point distance for the sacroiliac joint was 2.7 cm (IQR, 2.1-4.0), for the common iliac artery 4.1 cm (IQR, 3.2-5.0), for the external iliac artery 0 cm (IQR, 0.0-0.2), for the internal iliac artery 0.1 cm (IQR, 0-0.7), and for the iliac bifurcation 2.0 cm (IQR, 1.7-3.9). There were 60 % direct contact measurements for the iliac arteries.

Conclusion: This study shows that with adequately executed PPP a reasonable proximity of laparotomy packs to the potential bleeding sites to provide tamponade for arresting hemorrhage may be achieved.