Background: Application of vacuum-assisted closure (VAC™) in soft tissue defects after high-energy pelvic trauma is described as a retrospective study in a level one trauma center. Materials and methods: Between 2002 and 2004, 13 patients were treated for severe soft tissue injuries in the pelvic region. All musculoskeletal injuries were treated with multiple irrigation and debridement procedures and broad-spectrum antibiotics. VAC™ was applied as a temporary coverage for defects and wound conditioning. Results: The injuries included three patients with traumatic hemipelvectomies. Seven patients had pelvic ring fractures with five Morel-Lavallee lesions and two open pelviperineal trauma. One patient suffered from an open iliac crest fracture and a Morel-Lavallee lesion. Two patients sustained near complete pertrochanteric amputations of the lower limb. The average injury severity score was 34.1 ± 1.4. The application of VAC™ started in average 3.8 ± 0.4days after trauma and was used for 15.5 ± 1.8days. The dressing changes were performed in average every 3days. One patient (8%) with a traumatic hemipelvectomy died in the course of treatment due to septic complications. Conclusion: High-energy trauma causing severe soft tissues injuries requires multiple operative debridements to prevent high morbidity and mortality rates. The application of VAC™ as temporary coverage of large tissue defects in pelvic regions supports wound conditioning and facilitates the definitive wound closur
