Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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The Importance of the Trauma Surgeon: A Reflection on the Management of Hemodynamically Unstable Pelvic Trauma Patients

혈역학적으로 불안정한 골반외상 환자의 치료를 통해 본 외상전문의의 필요성

  • Shin, Sung (Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kyung, Kyu Hyuk (Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Ji Wan (Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Kim, Jung Jae (Department of Orthopedic Surgery, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Hong, Suk-Kyung (Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center)
  • 신성 (울산대학교 의과대학 서울아산병원 외과학교실) ;
  • 경규혁 (울산대학교 의과대학 서울아산병원 외과학교실) ;
  • 김지완 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 김정재 (울산대학교 의과대학 서울아산병원 정형외과학교실) ;
  • 홍석경 (울산대학교 의과대학 서울아산병원 외과학교실)
  • Received : 2009.10.22
  • Accepted : 2009.12.05
  • Published : 2009.12.30
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Abstract

Purpose: Pelvic trauma is a serious skeletal injury with high mortality. Especially in cases of severe injury trauma, treatment outcomes depend on early diagnosis and intervention. We expect trauma surgeon to play an important role in the management of severe multiple trauma patients. Methods: A retrospective study was performed on pelvic trauma patients with hemodynamic instability between March 2005 and September 2009. We divided the time period into period I (March 2005~Feburary 2009) and period II (March 2009~September 2009). The trauma surgeon and team started to work from period II. Data were collected regarding demographic characteristics, mechanism of injury, type of pelvic fracture, ISS(injury severity score), treatment modality, transfusion requirement, time to definitive treatment, and mortality. Results: During period I, among 7 hemodynamically unstable patients, 4(57.1%) patients died. However during Period II, only one of 6(16.6%) patients died. The demographic data and injury scores showed no differences between the two time periods, but the time to definitive treatment was very short with trauma team intervention(14.4 hrs vs. 3.9 hrs). Also, the amount of transfusion was less(41.1 U vs. 13.9 U). With arterial embolization, early pelvic external fixation led to less transfusion and made patients more stable. Conclusion: This study demonstrated the importance of the trauma surgeon and the trauma team in cases of hemodynamically unstable pelvic trauma. Even with the same facility and resources, an active trauma team approach can increase the survival of severely injured multiple trauma patients.

Keywords

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