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[Damage control surgery--a historical view].

Kunio Kobayashi1

  • 1Trauma and Critical Care Center, Teikyo University Hospital, Tokyo, Japan.

Nihon Geka Gakkai Zasshi
|July 30, 2002
PubMed
Summary

Damage control surgery is a life-saving strategy for critically injured patients, managing acidosis, hypothermia, and coagulopathy. This approach involves initial surgery, resuscitation, and definitive treatment, improving outcomes in severe trauma.

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Area of Science:

  • Trauma Surgery
  • Surgical Critical Care

Context:

  • The lethal triad of acidosis, hypothermia, and coagulopathy poses significant risks in severely injured patients.
  • Damage control surgery emerged as a strategy to manage these life-threatening conditions.
  • Early interventions like perihepatic packing and bail-out surgery laid the groundwork for modern damage control protocols.

Purpose:

  • To define and explain the concept of damage control surgery.
  • To outline the historical development and evolution of damage control surgery.
  • To discuss the application and limitations of damage control surgery in Japan.

Summary:

  • Damage control surgery is a staged surgical approach comprising initial laparotomy, secondary resuscitation, and definitive surgery.
  • It aims to mitigate the lethal triad (acidosis, hypothermia, coagulopathy) in critically injured patients.
  • Angiography and transcatheter arterial embolization (TAE) can be utilized during resuscitation for hemostasis.

Impact:

  • Damage control surgery has expanded beyond trauma to include other critically ill surgical patients.
  • The successful implementation of damage control surgery has improved survival rates in severe trauma.
  • Limited experience in Japan highlights the need for increased volume of severe trauma cases to refine its application.

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