Skip to main content
Top
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2016

Open Access 01-12-2016 | Review

Effectiveness of non invasive external pelvic compression: a systematic review of the literature

Authors: Peyman Bakhshayesh, Tarek Boutefnouchet, Anna Tötterman

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2016

Login to get access

Abstract

Introduction

Pelvic fractures might carry a significant risk of bleeding. A wide variety of pelvic binders together with pelvic sheets are available and offer an adjunct to the initial management of poly-trauma patients with pelvic injuries. These devices are collectively referred to as pelvic circumferential compression devices (PCCDs). The aim of this study was to review the literature for evidence pertinent to the efficacy and safety of PCCDs.

Methods

Using the PRISMA guidelines a systematic search on PubMed, Web of Science, CINAHL, Embase and Scopus was carried out. Articles included were in English language and published between 1999 and 2015. Studies included were appraised with narrative data synthesis.

Results

Seven articles addressed mechanical properties of non-invasive external mechanical devices, six articles focused on physiological aspects, and three studies evaluated the pressure characteristics of these devices. We found 4 case reports regarding adverse effects. None of the studies identified addressed the cost effectiveness or pain relief issues related to the use of PCCDs.

Conclusions

Based on available literature, PCCDs are widely used in the initial management of patients with suspected pelvic bleeding. There is evidence to suggest that external compression reduces disrupted pelvic rings. There are some complications reported following application of PCCDs. Hemorrhagic source and physiological effectiveness of PCCDs needs to be addressed in future studies. In the meantime judicious application of PCCDs will continue to be recommended.
Literature
1.
go back to reference Hauschild O, Strohm PC, Culemann U, Pohlemann T, Suedkamp NP, Koestler W, et al. Mortality in patients with pelvic fractures: Results from the German pelvic injury register. J Trauma. 2008;64:449–55.CrossRefPubMed Hauschild O, Strohm PC, Culemann U, Pohlemann T, Suedkamp NP, Koestler W, et al. Mortality in patients with pelvic fractures: Results from the German pelvic injury register. J Trauma. 2008;64:449–55.CrossRefPubMed
2.
go back to reference Young JW, Burgess AR, Brumback RJ, Poka A. Pelvic fractures: value of plain radiography in early assessment and management. Radiology. 1986;160:445–51.CrossRefPubMed Young JW, Burgess AR, Brumback RJ, Poka A. Pelvic fractures: value of plain radiography in early assessment and management. Radiology. 1986;160:445–51.CrossRefPubMed
3.
go back to reference Pennal GF, Tile M, Waddell JP, Garside H. Pelvic disruption: assessment and classification. Clin Orthop Relat Res. 1980;151:12–21. Pennal GF, Tile M, Waddell JP, Garside H. Pelvic disruption: assessment and classification. Clin Orthop Relat Res. 1980;151:12–21.
4.
go back to reference Subcommittee A, American College of Surgeons’ Committee on T, International Awg. Advanced trauma life support (ATLS(R)): the ninth edition. J Trauma Acute Care Surg. 2013;74:1363–6. Subcommittee A, American College of Surgeons’ Committee on T, International Awg. Advanced trauma life support (ATLS(R)): the ninth edition. J Trauma Acute Care Surg. 2013;74:1363–6.
5.
go back to reference Ganz R, Krushell RJ, Jakob RP, Kuffer J. The antishock pelvic clamp. Clin Orthop Relat Res. 1991;267:71–8. Ganz R, Krushell RJ, Jakob RP, Kuffer J. The antishock pelvic clamp. Clin Orthop Relat Res. 1991;267:71–8.
6.
go back to reference Lilja GP, Batalden DJ, Adams BE, Long RS, Ruiz E. Value of the counterpressure suit (M.A.S.T.) in pre-hospital care. Minn Med. 1975;58:540–3.PubMed Lilja GP, Batalden DJ, Adams BE, Long RS, Ruiz E. Value of the counterpressure suit (M.A.S.T.) in pre-hospital care. Minn Med. 1975;58:540–3.PubMed
7.
go back to reference Rubash HE, Mears DC. External fixation of the pelvis. Instr Course Lect. 1983;32:329–48.PubMed Rubash HE, Mears DC. External fixation of the pelvis. Instr Course Lect. 1983;32:329–48.PubMed
8.
go back to reference Vermeulen B, Peter R, Hoffmeyer P, Unger PF. Prehospital stabilization of pelvic dislocations: a new strap belt to provide temporary hemodynamic stabilization. Swiss Surg. 1999;5:43–6.CrossRefPubMed Vermeulen B, Peter R, Hoffmeyer P, Unger PF. Prehospital stabilization of pelvic dislocations: a new strap belt to provide temporary hemodynamic stabilization. Swiss Surg. 1999;5:43–6.CrossRefPubMed
9.
go back to reference Routt Jr ML, Falicov A, Woodhouse E, Schildhauer TA. Circumferential pelvic antishock sheeting: a temporary resuscitation aid. J Orthop Trauma. 2002;16:45–8.CrossRefPubMed Routt Jr ML, Falicov A, Woodhouse E, Schildhauer TA. Circumferential pelvic antishock sheeting: a temporary resuscitation aid. J Orthop Trauma. 2002;16:45–8.CrossRefPubMed
10.
go back to reference Spanjersberg WR, Knops SP, Schep NW, van Lieshout EM, Patka P, Schipper IB. Effectiveness and complications of pelvic circumferential compression devices in patients with unstable pelvic fractures: a systematic review of literature. Injury. 2009;40:1031–5.CrossRefPubMed Spanjersberg WR, Knops SP, Schep NW, van Lieshout EM, Patka P, Schipper IB. Effectiveness and complications of pelvic circumferential compression devices in patients with unstable pelvic fractures: a systematic review of literature. Injury. 2009;40:1031–5.CrossRefPubMed
11.
go back to reference Cullinane DC, Schiller HJ, Zielinski MD, Bilaniuk JW, Collier BR, Como J, et al. Eastern Association for the Surgery of Trauma practice management guidelines for hemorrhage in pelvic fracture--update and systematic review. J Trauma. 2011;71:1850–68.CrossRefPubMed Cullinane DC, Schiller HJ, Zielinski MD, Bilaniuk JW, Collier BR, Como J, et al. Eastern Association for the Surgery of Trauma practice management guidelines for hemorrhage in pelvic fracture--update and systematic review. J Trauma. 2011;71:1850–68.CrossRefPubMed
12.
go back to reference Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med. 2009;3:e123–30.PubMedPubMedCentral Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med. 2009;3:e123–30.PubMedPubMedCentral
13.
go back to reference Mason LW, Boyce DE, Pallister I. Catastrophic myonecrosis following circumferential pelvic binding after massive crush injury: a case report. Injury Extra. 2009;40:84–6.CrossRef Mason LW, Boyce DE, Pallister I. Catastrophic myonecrosis following circumferential pelvic binding after massive crush injury: a case report. Injury Extra. 2009;40:84–6.CrossRef
14.
go back to reference Schaller TM, Sims S, Maxian T. Skin breakdown following circumferential pelvic antishock sheeting: a case report. J Orthop Trauma. 2005;19:661–5.CrossRefPubMed Schaller TM, Sims S, Maxian T. Skin breakdown following circumferential pelvic antishock sheeting: a case report. J Orthop Trauma. 2005;19:661–5.CrossRefPubMed
15.
go back to reference Shank JR, Morgan SJ, Smith WR, Meyer FN. Bilateral peroneal nerve palsy following emergent stabilization of a pelvic ring injury. J Orthop Trauma. 2003;17:67–70.CrossRefPubMed Shank JR, Morgan SJ, Smith WR, Meyer FN. Bilateral peroneal nerve palsy following emergent stabilization of a pelvic ring injury. J Orthop Trauma. 2003;17:67–70.CrossRefPubMed
16.
go back to reference Krieg JC, Mohr M, Mirza AJ, Bottlang M. Pelvic circumferential compression in the presence of soft-tissue injuries: a case report. J Trauma. 2005;59:470–2.CrossRefPubMed Krieg JC, Mohr M, Mirza AJ, Bottlang M. Pelvic circumferential compression in the presence of soft-tissue injuries: a case report. J Trauma. 2005;59:470–2.CrossRefPubMed
17.
go back to reference Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869.CrossRefPubMedPubMedCentral Moher D, Hopewell S, Schulz KF, Montori V, Gotzsche PC, Devereaux PJ, et al. CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c869.CrossRefPubMedPubMedCentral
18.
go back to reference Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.CrossRefPubMed Slim K, Nini E, Forestier D, Kwiatkowski F, Panis Y, Chipponi J. Methodological index for non-randomized studies (minors): development and validation of a new instrument. ANZ J Surg. 2003;73:712–6.CrossRefPubMed
19.
go back to reference Bottlang M. Noninvasive reduction of open-book pelvic fractures by Circumferential Compression Michael. J Orthop Trauma. 2002;16:367–73.CrossRefPubMed Bottlang M. Noninvasive reduction of open-book pelvic fractures by Circumferential Compression Michael. J Orthop Trauma. 2002;16:367–73.CrossRefPubMed
20.
go back to reference DeAngelis NA, Wixted JJ, Drew J, Eskander MS, Eskander JP, French BG. Use of the trauma pelvic orthotic device (T-POD) for provisional stabilisation of anterior-posterior compression type pelvic fractures: a cadaveric study. Injury. 2008;39:903–6.CrossRefPubMed DeAngelis NA, Wixted JJ, Drew J, Eskander MS, Eskander JP, French BG. Use of the trauma pelvic orthotic device (T-POD) for provisional stabilisation of anterior-posterior compression type pelvic fractures: a cadaveric study. Injury. 2008;39:903–6.CrossRefPubMed
21.
go back to reference Prasarn ML, Horodyski M, Conrad B, Rubery PT, Dubose D, Small J, et al. Comparison of external fixation versus the trauma pelvic orthotic device on unstable pelvic injuries: a cadaveric study of stability. J Trauma Acute Care Surg. 2012;72:1671–5.CrossRefPubMed Prasarn ML, Horodyski M, Conrad B, Rubery PT, Dubose D, Small J, et al. Comparison of external fixation versus the trauma pelvic orthotic device on unstable pelvic injuries: a cadaveric study of stability. J Trauma Acute Care Surg. 2012;72:1671–5.CrossRefPubMed
22.
go back to reference Prasarn ML. Does application position of the T-POD affect stability of pelvic fractures? J Orthop Trauma. 2013;27:262–6.CrossRefPubMed Prasarn ML. Does application position of the T-POD affect stability of pelvic fractures? J Orthop Trauma. 2013;27:262–6.CrossRefPubMed
23.
go back to reference Prasarn ML, Conrad B, Small J, Horodyski M, Rechtine GR. Comparison of circumferential pelvic sheeting versus the T-POD on unstable pelvic injuries: a cadaveric study of stability. Injury. 2013;44:1756–9.CrossRefPubMed Prasarn ML, Conrad B, Small J, Horodyski M, Rechtine GR. Comparison of circumferential pelvic sheeting versus the T-POD on unstable pelvic injuries: a cadaveric study of stability. Injury. 2013;44:1756–9.CrossRefPubMed
24.
go back to reference Knops SP, Schep NW, Spoor CW, van Riel MP, Spanjersberg WR, Kleinrensink GJ, et al. Comparison of three different pelvic circumferential compression devices: a biomechanical cadaver study. J Bone Joint Surg Am. 2011;93:230–40.CrossRefPubMed Knops SP, Schep NW, Spoor CW, van Riel MP, Spanjersberg WR, Kleinrensink GJ, et al. Comparison of three different pelvic circumferential compression devices: a biomechanical cadaver study. J Bone Joint Surg Am. 2011;93:230–40.CrossRefPubMed
25.
go back to reference Hedrick-Thompson JK. A review of pressure reduction device studies. J Vasc Nurs. 1992;10:3–5.PubMed Hedrick-Thompson JK. A review of pressure reduction device studies. J Vasc Nurs. 1992;10:3–5.PubMed
26.
27.
go back to reference Knops SP, van Riel MP, Goossens RH, van Lieshout EM, Patka P, Schipper IB. Measurements of the exerted pressure by pelvic circumferential compression devices. Open Orthop J. 2010;4:101–6.PubMedPubMedCentral Knops SP, van Riel MP, Goossens RH, van Lieshout EM, Patka P, Schipper IB. Measurements of the exerted pressure by pelvic circumferential compression devices. Open Orthop J. 2010;4:101–6.PubMedPubMedCentral
28.
go back to reference Tan ECTH, van Stigt SFL, van Vugt AB. Effect of a new pelvic stabilizer (T-POD®) on reduction of pelvic volume and haemodynamic stability in unstable pelvic fractures. Injury. 2010;41:1239–43.CrossRefPubMed Tan ECTH, van Stigt SFL, van Vugt AB. Effect of a new pelvic stabilizer (T-POD®) on reduction of pelvic volume and haemodynamic stability in unstable pelvic fractures. Injury. 2010;41:1239–43.CrossRefPubMed
29.
go back to reference Pizanis A, Pohlemann T, Burkhardt M, Aghayev E, Holstein JH. Emergency stabilization of the pelvic ring: clinical comparison between three different techniques. Injury. 2013;44:1760–4.CrossRefPubMed Pizanis A, Pohlemann T, Burkhardt M, Aghayev E, Holstein JH. Emergency stabilization of the pelvic ring: clinical comparison between three different techniques. Injury. 2013;44:1760–4.CrossRefPubMed
30.
go back to reference Croce MA, Magnotti LJ, Savage SA, Wood 2nd GW, Fabian TC. Emergent pelvic fixation in patients with exsanguinating pelvic fractures. J Am Coll Surg. 2007;204:935–9. discussion 40-2.CrossRefPubMed Croce MA, Magnotti LJ, Savage SA, Wood 2nd GW, Fabian TC. Emergent pelvic fixation in patients with exsanguinating pelvic fractures. J Am Coll Surg. 2007;204:935–9. discussion 40-2.CrossRefPubMed
31.
go back to reference Ghaemmaghami V, Sperry J, Gunst M, Friese R, Starr A, Frankel H, et al. Effects of early use of external pelvic compression on transfusion requirements and mortality in pelvic fractures. Am J Surg. 2007;194:720–3. discussion 3.CrossRefPubMed Ghaemmaghami V, Sperry J, Gunst M, Friese R, Starr A, Frankel H, et al. Effects of early use of external pelvic compression on transfusion requirements and mortality in pelvic fractures. Am J Surg. 2007;194:720–3. discussion 3.CrossRefPubMed
32.
go back to reference Fu CY, Wu YT, Liao CH, Kang SC, Wang SY, Hsu YP, et al. Pelvic circumferential compression devices benefit patients with pelvic fractures who need transfers. Am J Emerg Med. 2013;31:1432–6.CrossRefPubMed Fu CY, Wu YT, Liao CH, Kang SC, Wang SY, Hsu YP, et al. Pelvic circumferential compression devices benefit patients with pelvic fractures who need transfers. Am J Emerg Med. 2013;31:1432–6.CrossRefPubMed
33.
go back to reference Nunn T, Cosker TD, Bose D, Pallister I. Immediate application of improvised pelvic binder as first step in extended resuscitation from life-threatening hypovolaemic shock in conscious patients with unstable pelvic injuries. Injury. 2007;38:125–8.CrossRefPubMed Nunn T, Cosker TD, Bose D, Pallister I. Immediate application of improvised pelvic binder as first step in extended resuscitation from life-threatening hypovolaemic shock in conscious patients with unstable pelvic injuries. Injury. 2007;38:125–8.CrossRefPubMed
34.
go back to reference Mason LWBD, Pallister I. Catastrophic myonecrosis following circumferential pelvic binding after massive crush injury: A case report. Injury Extra. 2009;2009(40):84–6.CrossRef Mason LWBD, Pallister I. Catastrophic myonecrosis following circumferential pelvic binding after massive crush injury: A case report. Injury Extra. 2009;2009(40):84–6.CrossRef
35.
go back to reference Balogh Z, Caldwell E, Heetveld M, D’Amours S, Schlaphoff G, Harris I, et al. Institutional practice guidelines on management of pelvic fracture-related hemodynamic instability: do they make a difference? J Trauma. 2005;58:778–82.CrossRefPubMed Balogh Z, Caldwell E, Heetveld M, D’Amours S, Schlaphoff G, Harris I, et al. Institutional practice guidelines on management of pelvic fracture-related hemodynamic instability: do they make a difference? J Trauma. 2005;58:778–82.CrossRefPubMed
36.
go back to reference Davis JW, Moore FA, McIntyre Jr RC, Cocanour CS, Moore EE, West MA. Western trauma association critical decisions in trauma: management of pelvic fracture with hemodynamic instability. J Trauma. 2008;65:1012–5.CrossRefPubMed Davis JW, Moore FA, McIntyre Jr RC, Cocanour CS, Moore EE, West MA. Western trauma association critical decisions in trauma: management of pelvic fracture with hemodynamic instability. J Trauma. 2008;65:1012–5.CrossRefPubMed
39.
go back to reference Grimm MR, Vrahas MS, Thomas KA. Pressure-volume characteristics of the intact and disrupted pelvic retroperitoneum. J Trauma. 1998;44:454–9.CrossRefPubMed Grimm MR, Vrahas MS, Thomas KA. Pressure-volume characteristics of the intact and disrupted pelvic retroperitoneum. J Trauma. 1998;44:454–9.CrossRefPubMed
40.
go back to reference Bonner TJ, Eardley WG, Newell N, Masouros S, Matthews JJ, Gibb I, et al. Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring. J Bone Joint Surg (Br). 2011;93:1524–8.CrossRef Bonner TJ, Eardley WG, Newell N, Masouros S, Matthews JJ, Gibb I, et al. Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring. J Bone Joint Surg (Br). 2011;93:1524–8.CrossRef
41.
42.
go back to reference Enninghorst N, Toth L, King KL, McDougall D, Mackenzie S, Balogh ZJ. Acute definitive internal fixation of pelvic ring fractures in polytrauma patients: a feasible option. J Trauma. 2010;68:935–41.CrossRefPubMed Enninghorst N, Toth L, King KL, McDougall D, Mackenzie S, Balogh ZJ. Acute definitive internal fixation of pelvic ring fractures in polytrauma patients: a feasible option. J Trauma. 2010;68:935–41.CrossRefPubMed
43.
44.
go back to reference Giannoudis PV, Pape HC. Damage control orthopaedics in unstable pelvic ring injuries. Injury. 2004;35:671–7.CrossRefPubMed Giannoudis PV, Pape HC. Damage control orthopaedics in unstable pelvic ring injuries. Injury. 2004;35:671–7.CrossRefPubMed
45.
go back to reference Rommens PM, Hessmann MH. Staged reconstruction of pelvic ring disruption: differences in morbidity, mortality, radiologic results, and functional outcomes between B1, B2/B3, and C-type lesions. J Orthop Trauma. 2002;16:92–8.CrossRefPubMed Rommens PM, Hessmann MH. Staged reconstruction of pelvic ring disruption: differences in morbidity, mortality, radiologic results, and functional outcomes between B1, B2/B3, and C-type lesions. J Orthop Trauma. 2002;16:92–8.CrossRefPubMed
46.
go back to reference Stover MD, Summers HD, Ghanayem AJ, Wilber JH. Three-dimensional analysis of pelvic volume in an unstable pelvic fracture. J Trauma. 2006;61:905–8.CrossRefPubMed Stover MD, Summers HD, Ghanayem AJ, Wilber JH. Three-dimensional analysis of pelvic volume in an unstable pelvic fracture. J Trauma. 2006;61:905–8.CrossRefPubMed
Metadata
Title
Effectiveness of non invasive external pelvic compression: a systematic review of the literature
Authors
Peyman Bakhshayesh
Tarek Boutefnouchet
Anna Tötterman
Publication date
01-12-2016
Publisher
BioMed Central
DOI
https://doi.org/10.1186/s13049-016-0259-7

Other articles of this Issue 1/2016

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2016 Go to the issue