A 67-year-old man experienced crushing injury. His left leg had been sucked in the wheel of a tractor. The patient’s systolic blood pressure and hemoglobin levels were 50 mmHg and 7.5 g/dl, respectively, upon admission. The large defect of leg wound was considered to need to be amputated above the knee. A large volume of bloody discharge was observed in the perineal wound and leg stump wound. After the femoral vein and artery were ligated during amputation surgery, to control the bloody oozing pad packing to perineal and thigh stump wounds was performed and approximation with suture was done to compress the wound (Fig. 1). After pad packing, the bloody discharge has been stopped without additional angioembolization. Likely other abdominal injuries, the hemodynamically unstable crushing perineal and leg stump were treated safely by damage control surgery with pad packing [1,2].

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