Traumatic Hemipelvectomy

Late presentation with whole limb gangrene following open traumatic hemipelvectomy

“…Traumatic hemipelvectomy is a relatively rare and severe injury, making up about 2.4% of pelvic injuries [4]. The high mortality rate following this devastating injury is a reXection of the rapid sequence of circulatory compromise leading ultimately to exsanguination and death eventually.…”

“…This was divided without any incident to complete the separation of the limb from the trunk (see Figs. 3,4). The neurovascular bundles were not visualized in the Xoor of the wound which contained foul smelly necrotic tissue.…”

“…They cause disruption to the symphysis pubis and sacroiliac joints, which is the usual plane of separation in as many as 71% of cases [4]. Other mechanisms which have been described include strong traction forces or direct avulsion of the limb [3,4,7,[10][11][12] and massive crushing forces to the pelvis [10]. In this patient, it would appear that the mechanism of injury was a side swipe injury with the on-coming car.…”

“…In particular, side swipe injuries involving motor or pedal cyclist have been reported in the literature as the commonest mechanism, accounting for about 40% of all cases of traumatic hemipelvectomy [2,8,9]. They cause disruption to the symphysis pubis and sacroiliac joints, which is the usual plane of separation in as many as 71% of cases [4]. Other mechanisms which have been described include strong traction forces or direct avulsion of the limb [3,4,7,[10][11][12] and massive crushing forces to the pelvis [10].…”

V.A.C. Instill® therapy – indications and technical applications

“…In 2005 and 2006 Labler and Trentz reported an in vitro model which analysed the commercial V.A.C. Instill ® therapy settings [27,28].…”