UROGENITAL TRAUMA

Infection of non-operatively managed acetabular fracture via a suprapubic catheter
Karmani S, Lee J, Kinmont C, Day A
Department of Trauma and Orthopaedic Surgery, Pelvic and Acetabular Reconstruction Unit, St. George’s Hospital Medical School, London, UK
Injury. 2003; 34: 550-1.

Case Report - Abstract not available

• Editorial Comment
  It finally happened. A documented case of suprapubic catheter infecting a pelvic fracture. While orthopedic surgeons commonly warn of this potential complication, real evidence that it is a concern has never been found in the literature. This case is the first report I have seen documenting that an infected suprapubic tube tract infected a pelvic fracture: in this case a relatively distant acetabular fracture. Most orthopedists, it seems, are worried about the infection of pubic rami fractures.
  Because I have not been convinced that suprapubic tubes cause a significant number of orthopedic infections, I do not hesitate to use them when necessary. Those times when I must place an open suprapubic tube (perhaps for posterior urethral distraction injury when I am unable to place a catheter endoscopically) I do modify the way I perform the operation, attempting to keep the catheter as far away from the broken pelvis as possible. I tunnel the catheter out the dome of the bladder, through the peritoneal space, and bring it out of the skin at the most superior location possible - sometimes even supraumbilically.

Dr. Richard A. Santucci
Assistant Professor of Urology
Wayne State University
Detroit, Michigan, USA