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Related Experiment Videos

Damage control surgery for abdominal trauma.

Masoud M Bashir1, Fikri M Abu-Zidan

  • 1Accident and Emergency Department, Al-Ain Hospital, Al-Ain, UAE. masoudbashir@hotmail.com

The European Journal of Surgery. Supplement. : = Acta Chirurgica. Supplement
|June 18, 2004
PubMed
Summary

Damage control surgery is an effective approach for critically injured patients with complex trauma, involving rapid hemorrhage control and physiological resuscitation before definitive repair. This method, while having a high mortality rate, offers a vital alternative in emergency surgical management.

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Area of Science:

  • Surgical Trauma Management
  • Emergency Medicine
  • Critical Care Surgery

Background:

  • Damage control surgery is a strategy for managing critically injured patients with complex or multiple injuries.
  • It addresses physiological derangements such as hypothermia, coagulopathy, and metabolic acidosis.
  • The traditional surgical approach may be inadequate in patients with severe exsanguination and tissue edema.

Purpose of the Study:

  • To review the physiology, indications, technical aspects, morbidity, and mortality associated with damage control surgery.
  • To provide an overview of the established principles and phases of damage control surgery.
  • To assess the role of damage control surgery as an alternative to traditional management.

Main Methods:

  • A retrospective review of published literature was conducted.

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  • A MEDLINE search for articles on damage control surgery from 1981 to 2001 was performed.
  • Additional relevant articles were identified through the reference lists of primary sources.

    • Main Results:

    • Indications include exsanguinating hemorrhage, coagulopathy, hypothermia, and inability to control bleeding or close the abdomen due to massive edema.
    • The procedure involves three phases: initial hemorrhage control and bowel management, physiological resuscitation, and planned reoperation for definitive repair.
    • Damage control surgery is indicated for a select group of critically ill patients and is associated with a high mortality rate (mean 45%).

    Conclusions:

    • Damage control surgery presents a simple and effective alternative for managing complex or multiple injuries in critically injured patients.
    • Phases I and II of damage control surgery can be performed in rural settings prior to transfer to a major trauma center for definitive repair.
    • This approach is crucial for patients with severe physiological compromise who are at high risk of operative death.