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Re: Операция на переднем полукольце таза при налич
David Zamorano 04 Июнь 2007, 17:45
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Alexander,
here are some more details:
What do you mean as "prep the SP catheter into the field"?
the suprapubic catheter is clamped and disconnected from the collection bag. It is then scrubbed and prepped and draped into the field. We then do an ilioinguinal or Pfannenstiel depending on the fracture.
What bladder repair do you mean?
usually the bladder has been repaired already but some times it has not been or it has been repaired inadequately. The typical scenario is a patient who is transferred from another hospital for definitive care for their pelvic fractures. Often they have an emergent ex-lap by the general surgeons and a suprapubic catheter placed by the urologist but don't have an orthopaedist to fix the pelvis. When we do our approach, we inspect the bladder and if it needs to be repaired, the urologist does this.
Is it temporary closure of the fistula and re-opening it again after closure of the
>"orthopaedic" aproach?
the fistula is allowed to heal on it's own and the new catheter is placed through a "clean" site in the skin. sometimes a catheter is not needed and a foley can be placed. if there is a urethral repair that is needed, this is done at another time by the urologist
hope this helps
Dave
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Re: Операция на переднем полукольце таза при налич
Отправитель: Alexander Chelnokov 04 Июнь 2007, 19:05
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THX for your expalanation.
> bag. It is then scrubbed and prepped and draped into the field. We
> then do an ilioinguinal or Pfannenstiel depending on the fracture.
Got it.
> transferred from another hospital for definitive care for their
> pelvic fractures. Often they have an emergent ex-lap by the general
> surgeons and a suprapubic catheter placed by the urologist but don't
> have an orthopaedist to fix the pelvis.
Our most typical scenario.
> When we do our approach, we inspect the bladder and if it needs to
> be repaired, the urologist does this.
The difference is that we don't have urologists avalaible. And more often the tube is in place because of urethra injury.
>not needed and a foley can be placed. if there is a urethral repair
>that is needed, this is done at another time by the urologist
This case is most actual - in case of further delayed urethral repair the "old" SP tube also should be removed and new one incerted through the intact skin after the ORIF? THX again.
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