Measurements of the Exerted Pressure by Pelvic Circumferential Compression Devices

Abstract

Abstract:Background: Data on the efficacy and safety of non-invasive Pelvic Circumferential Compression Devices (PCCDs) is limited. Tissue damage may occur if a continuous pressure on the skin exceeding 9.3 kPa is sustained for more than two or three hours. The aim of this study was to gain insight into the pressure build-up at the interface, by measuring the PCCD-induced pressure when applying pulling forces to three different PCCDs (Pelvic Binder ® , SAMSling ® and T-POD ® ) in a simplified model. Methods:The resulting exerted pressures were measured at four 'anatomical' locations (right, left, posterior and anterior) in a model using a pressure measurement system consisting of pressure cuffs. Results:The exerted pressure varied substantially between the locations as well as between the PCCDs. Maximum pressures ranged from 18.9-23.3 kPa and from 19.2-27.5 kPa at the right location and left location, respectively. Pressures at the posterior location stayed below 18 kPa. At the anterior location pressures varied markedly between the different PCCDs. Conclusion:The circumferential compression by the different PCCDs showed high pressures measured at the four locations using a simplified model. Difference in design and functional characteristics of the PCCDs resulted in different pressure build-up at the four locations. When following the manufacturer's instructions, the exerted pressure of all three PCCDs tested exceeded the tissue damaging level (9.3 kPa). In case of prolonged use in a clinical situation this might put patients at risk for developing tissue damage.

Effect of Pelvic Binder Placement on OTA Classification of Pelvic Ring Injuries Using Computed Tomography. Does It Mask the Injury?

“…1 Life-threatening retroperitoneal hemorrhage can occur because of shearing of the pelvic vessels and bleeding from fractured bone ends. [4][5][6][7][8][9][10][11] The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve this effect has become commonplace and is a well established component of ATLS. [4][5][6][7][8][9][10][11] The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve this effect has become commonplace and is a well established component of ATLS.…”

“…2,3 Early pelvic stabilization is postulated to help prevent exsanguination by both decreasing pelvic volume, limiting interfragmentary motion, and thus permitting stable clot formation. [4][5][6][7][8][9][10][11][12][13][14][15] Both commercial binders and traditional sheeting techniques seem to be effective at reducing pelvic volume. [4][5][6][7][8][9][10][11][12][13][14][15] Both commercial binders and traditional sheeting techniques seem to be effective at reducing pelvic volume.…”

“…[4][5][6][7][8][9][10][11] The use of a noninvasive pelvic circumferential compression device (PCCD) to achieve this effect has become commonplace and is a well established component of ATLS. 5,7,10,[13][14][15] PCCDs are utilized at major trauma centers, as well as prehospital and pretransfer settings. 5,7,10,[13][14][15] PCCDs are utilized at major trauma centers, as well as prehospital and pretransfer settings.…”

„Clear-the-Pelvis-Algorithmus“: Handlungsempfehlung zur Freigabe des Beckens nach nicht invasiver Stabilisierung mittels Beckengurt im Rahmen der Schockraumversorgung

“…zu korrigieren, weil ein unkorrekt liegender Gurt i. d. R. wirkungslos bleibt [9]. Es liegen neben den biomechanischen Studien über die optimale Wirksamkeit des Pelvic Binders bei einer Positionierung über der Trochanter-major-Region [10] auch entsprechende klinische Fallberichte vor [9]. Eine Umfrage aus England lässt eine Positionierung eines Pelvic Binders mehrheitlich (zwischen 40 und 79 %) auf Höhe der Trochanteres erwarten [5].…”

The pelvic belt: a cautionary tale of pressure necrosis

“…The pressure exerted by the belt will cause necrosis of the soft tissues after a short period of time (see figure 1). 1 If the area of pressure necrosis involves the ‘operative field’ then open reduction and internal fixation will not be possible due to the increased risk of infection. As a consequence, the patient may develop a pelvic mal-union, which is associated with a poor outcome, disabling symptoms and has major socioeconomic implications.…”