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Damage Control Surgery

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Penetrating Trauma

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Abstract

Damage control is one of the key concepts to have 4 emerged in the Management of Severe Trauma in the 5 past st 25 years. It refers to an abbreviated staged surgical procedure anywhere in the body (Laparotomy, Shunting of Vessels, External 27 fixation, etc.) done on a patient in physiological 28 extremes in order to minimize the insult of the surgery, 29 as pointed out above, we must always be on the look-93 out for the development of the deadly triad of coagul-940pathy, acidosis, and hypothermia both pre- and 95intra-operatively in order to be ready to implement96 damage control surgery as soon as needed. This procedure comprises 5 stages, from temporizing measures to ICU resucitation to definitive surgery and final reconstruction. Selection for patients suitable for damage control should be done early, sometimes just based on mechanism of injury. The surgical techniques at the initial operation centre on haemorrhage and contamination control, followed by temporary closure. Optimization if the patient in the intensive care unit is followed by revision procedures once various parameters are normalizing. Controversies still exist on the ideal type of temporary closure, colonic continuity restoration, the ideal management of arterial bleeding, and how to ensure abdominal closure.

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Authors and Affiliations

  1. Trauma and Burns Unit, Chris Hani Baragwanath Hospital, University of the Witwatersrand Medical School, 7 York Road, Parktown, 2193, Johannesburg, Republic of South Africa

    Frank Plani & Riaan Pretorius

Authors
  1. Frank Plani
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  2. Riaan Pretorius
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Correspondence to Frank Plani .

Editor information

Editors and Affiliations

  1. Dept. Surgery, Massachusetts General Hospital, Fruit Street 55, Boston, 02114, Massachusetts, USA

    George C. Velmahos

  2. Medical School, Dept. Surgery, University of Witwatersrand, York Road 7, Johannesburg, 2193, South Africa

    Elias Degiannis

  3. Klinik für Viszeral-, Thorax- und, Gefäßchirurgie, Univ.Klinikum Marburg, Baldingerstraße, Marburg, 35043, Germany

    Dietrich Doll

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© 2012 Springer Berlin Heidelberg

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Plani, F., Pretorius, R. (2012). Damage Control Surgery. In: Velmahos, G., Degiannis, E., Doll, D. (eds) Penetrating Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-20453-1_40

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  • DOI: https://doi.org/10.1007/978-3-642-20453-1_40

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-20452-4

  • Online ISBN: 978-3-642-20453-1

  • eBook Packages: MedicineMedicine (R0)

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