Surgical hemostatic options for damage control of pelvic fractures

The diagnosis and treatment of pelvic ring disruption has significantly changed over the past 30 years.It was not until the 1980s that the concept of damage control surgery was applied in the management of severely traumatized patients.The contents of damage control surgery mainly include three phases:the initial stage,the goal of severe pelvic trauma treatment is using simple surgical techniques to control life-threatening bleeding;the second stage,the physiological disturbances of the patients were corrected by ICU resuscitation;and the third stage,the definitive surgery performed for the injuries.1 About 10％ to 20％ of patients with severe unstable pelvic fracture also present with hemodynamic instability,and the mortality rate of them can be as high as 40％.2-4 Although hemodynamic resuscitation techniques have made great progress,some patients do not respond or poorly respond to resuscitation treatment.In this case,according to the principle of damage control,timely and decisively implement of appropriate as well as effective surgical hemostasis is necessary.What's more,any surgical intervention must be considered immediately life-saving.The first step to control the hemorrhage is to restore pelvic stability and compress pelvis volume;now external fixator or C-clamp is often used,in order to reduce bleeding,and use some surgical options further to control the bleeding.