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[Damage control surgery].

K Ikegami1

  • 1Trauna and Critical Care Center Koshigaya Hospital, Dokkyo University School of Medicine, Japan.

Nihon Geka Gakkai Zasshi
|September 11, 1999
PubMed
Summary
This summary is machine-generated.

Damage control surgery is a strategy to prevent trauma deaths by controlling hemorrhage and contamination, followed by resuscitation and definitive repair. This approach aims to mitigate hypothermia, acidosis, and coagulopathy in severely injured patients.

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[PREFACE TO “WOUND CLOSURE METHODS FOR PREVENTION OF SURGICAL SITE INFECTION AND PATHOLOGIC SCARS ― INCISION AND SUTURE METHODS FOR PREVENTION OF SSI, HYPERTROPHIC SCARS AND KELOID ―”].

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Area of Science:

  • Traumatology
  • Surgical Critical Care
  • Emergency Medicine

Context:

  • Exsanguinating torso injuries in trauma patients often lead to lethal triad: hypothermia, metabolic acidosis, and coagulopathy.
  • Current trauma management strategies may not adequately address these pre-mortem physiological derangements.

Purpose:

  • To introduce and describe the strategy of damage control surgery for managing exsanguinating torso trauma.
  • To outline the phases and goals of damage control surgery, including initial damage control, physiological resuscitation, and definitive repair.

Summary:

  • Damage control surgery involves immediate control of hemorrhage and contamination, followed by intensive care unit (ICU) resuscitation to restore physiological stability.
  • Definitive surgical repair is planned after secondary resuscitation in the ICU, typically within 36 hours.

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  • Abdominal compartment syndrome is a potential complication requiring consideration for early decompression surgery.

    • Impact:

    • This strategy aims to prevent pre-mortem physiological collapse and reduce mortality in patients with severe torso trauma.
    • It provides a structured approach to managing complex injuries, optimizing patient outcomes through staged interventions.
    • Highlights the importance of recognizing and managing complications like abdominal compartment syndrome.