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Bleeding noted with pelvis fractures is predominantly due to associated venous complex injuries. More studies are advocating for angiography as first\u2010line therapy for haemodynamic instability in pelvic fractures; however, these facilities are not in abundance in middle\u2010 and low\u2010income countries. We hypothesized that PPP improves outcomes under these circumstances.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis of data from the patients charts over a period of 16 years from 01\u00a0January, 2005 to 31 December, 2020. All patients over the age of 18 years who presented with haemodynamic instability from a pelvic fracture and required PPP were included. The demographics, physiological parameter in emergency department, blood products transfused, morbidity and mortality were analysed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 110 patients identified in the study period who underwent pelvic preperitoneal packing for refractory shock or ongoing bleeding. The majority (75.5%) of patients were men (<jats:italic>n<\/jats:italic>\u2009=\u200983). The median age was 38 years. The most common mechanism of injury was pedestrian vehicle collision (51%), followed by motor vehicle collisions (27.3%). The median ISS and NISS were 35 and 40, respectively. The median RTS in ED was 4.8(3\u20136.8). None of our patients rebleed after pack removal and no one needed repacking or adjunct angioembolization in our study group. The in\u2010hospital mortality rate was 43.6% (<jats:italic>n<\/jats:italic>\u2009=\u200948) in patients who underwent preperitoneal pelvic packing. The operating room table mortality was 20% (<jats:italic>n<\/jats:italic>\u2009=\u200922\/110), and the mortality rate of those who survived to ICU transfer was 29.5% (<jats:italic>n\u2009=\u2009<\/jats:italic>26\/88).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Pelvic preperitoneal packing has a role in the acute management of haemodynamically abnormal patients with pelvic fractures in our environment. In the absence of immediate angioembolization, preperitoneal packing can be lifesaving.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07173-4","type":"journal-article","created":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T23:03:28Z","timestamp":1694905408000},"page":"2651-2658","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Role for Preperitoneal Pelvic Packing in Low\u2010to\u2010Middle\u2010Income Countries: A 16\u2010Year Experience at a Johannesburg Trauma Unit"],"prefix":"10.1002","volume":"47","author":[{"given":"Maeyane Stephens","family":"Moeng","sequence":"first","affiliation":[{"name":"Department of Surgery School of Clinical Medicine Faculty of Health Sciences University of the Witwatersrand 2193 Johannesburg South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francois","family":"Viljoen","sequence":"additional","affiliation":[{"name":"Department of 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