CPT® Code 49013

Preperitoneal pelvic packing (PPP) is a surgical procedure utilized to manage hemorrhage resulting from pelvic trauma, particularly in patients who are hemodynamically unstable. This condition often arises following significant injuries such as pelvic bone fractures or damage to intra-pelvic organs. The procedure involves creating an incision in the abdominal wall to access the pelvic cavity, allowing for the placement of packing materials to control bleeding. The incision can be made using a midline vertical approach, extending from the pubic symphysis to just below the umbilicus, or through a Pfannenstiel incision, which is a horizontal cut typically used in gynecological surgeries. During the operation, the surgeon carefully dissects through various layers of tissue, including the subcutaneous tissue, linea alba, and peritoneum, to reach the pelvic area. Once accessed, the surgeon can identify and address any hematomas or bleeding sources within the preperitoneal, paravesical, or presacral spaces. The procedure is critical in stabilizing patients by controlling venous bleeding and preventing further complications associated with pelvic trauma.