• P D Faringer, R J Mullins, P D Feliciano, P J Duwelius, and D D Trunkey.
• Department of Surgery, Oregon Health Sciences University, Portland.
• Arch Surg Chicago. 1994 Sep 1;129(9):958-63; discussion 963-4.

ObjectiveTo review the outcomes of patients with open pelvic fractures.DesignRetrospective review of medical records.SettingPatients admitted from the injury scene or transferred within 24 hours to a level 1 trauma center.PatientsThirty-three patients sustaining blunt trauma had pelvic fractures and adjacent wounding.InterventionsTreatment protocol that included selective fecal diversion, measures to arrest hemorrhage and prevent wound sepsis, manage associated pelvic injuries, and provide optimal orthopedic outcomes.Main Outcome MeasuresDeath and sepsis.ResultsExsanguination occurred in one patient and death owing to head injuries occurred in five patients. Wound sepsis occurred in 31% of patients with colostomy and 19% without colostomy.ConclusionsManagement of open pelvic fractures requires a well-coordinated group using several techniques. Selected patients with open pelvic fractures do not require fecal diversion. Incisions for orthopedic surgery should be considered when decisions are made regarding fecal diversion.

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