Abstract：
Background: Preperitoneal pelvic packing (PPP) and external fixation has led to improved mortality after devastating pelvic trauma. However, there is limited literature on infection after this intervention. We aim to study the risk factors associated with pelvic infection after PPP. Patients and Methods: A retrospective review of patients who underwent PPP at a single level 1 trauma center was performed. Results: Over the 18-year study period, 222 patients were identified. Twenty-three percent of patients had an open fracture. Pelvic angiography was performed in 24% of patients with 16% requiring angioembolization (AE). The average time to packing removal was two (one to two days) days, although 10% of patients had their pelvis re-packed. Overall infection rate was 14% (n = 31); if pelvic re-packing was performed, the infection rate increased to 45%. Twenty-two of the patients with an infection required additional procedures for their infection, and ultimately hardware removal occurred in eight patients. On univariable analysis, patients with pelvic infections had more open fractures (55% vs. 17%; p < 0.01), underwent AE more frequently (29% vs. 14%; p = 0.04), were more likely to undergo repacking (32% vs. 6%; p < 0.01), and had packing in place for longer (2 [1,2] vs. 2 [2,3]; p = 0.01). On logistic multivariable regression analysis, open fracture (odds ratio [OR], 5.8; 95% confidence interval [CI], 2.4-14.1) and pelvic re-packing (OR, 4.7; 95% CI, 1.2-18.5) were independent risk factors for pelvic infection. Conclusions: Pelvic infection after PPP is a serious complication independently associated with open fracture and re-packing of the pelvis. Re-intervention was required in most patients with infection.
摘要：
背景：腹膜前盆腔填塞（PPP）和外固定支架可改善破坏性盆腔创伤后的死亡率。然而,在此干预后，关于感染的文献有限。目的研究PPP术后盆腔感染的危险因素。患者和方法：对在单个1级创伤中心接受PPP的患者进行了回顾性分析。结果：在18年的研究期间，222名患者被确认。23％的患者患有开放性骨折。24％的患者进行了盆腔血管造影，其中16％需要血管栓塞（AE）。去除包装的平均时间是两天（一到两天），尽管10％的患者进行了骨盆重新包装。总感染率为14%(n=31);如果进行盆腔再填塞,感染率上升到45%。22名感染患者需要额外的感染程序，并最终在8名患者中进行硬件移除。关于单变量分析，骨盆感染患者有更多的开放性骨折(55%vs.17%；p<0.01)，更频繁地接受AE（29%与14%；p=0.04），更有可能接受重新包装(32%与6%；p<0.01)，并且包装时间更长(2[1,2]vs.2[2,3]；p=0.01）。在Logistic多元回归分析中，开放性骨折(比值比[OR]，5.8；95%置信区间[CI]，2.4-14.1)和骨盆重新包装(或,4.7；95%CI，1.2～18.5）是盆腔感染的独立危险因素。结论：PPP术后盆腔感染是一种严重的并发症，与开放性骨折和骨盆重新填充独立相关。大多数感染患者需要再次干预。
