[Damage control surgery and perioperative management]

In damage control surgery, not only successful surgical procedures but also general management are crucial. Specifically, body temperature maintenance and aortic occlusion are major strategies supporting damage control surgery. Strategies for maintaining body temperature should be initiated at the scene of the incident by prehospital care providers. Radiant warmers should be installed in the ceilings of emergency rooms, and powerful warmers for fluids and blood, e.g., System 1000, should be utilized. Water blankets and the Bear Hugger system are also effective in maintaining patient body temperature. We have been successful in avoiding decreases in temperature during laparotomy using a combination of those strategies. In cases of massive hemoperitoneum aortic occlusion prior to abdominal incision is recommended to avoid cardiac arrest. We developed an intraaortic balloon occluder (Block Balloon) and inserted it in 26 patients undergoing damage control surgery. Ten patients survived, for a survival rate of 61.5%.