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Combat damage control surgery.

Lorne H Blackbourne1

  • 1Trauma Service, Brooke Army Medical Center, U.S. Army Institute of Surgical Research, Fort Sam Houston, TX, USA. lorne.blackbourne@amedd.army.mil

Critical Care Medicine
|July 18, 2008
PubMed
Summary
This summary is machine-generated.

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Combat damage control surgery, unlike civilian practices, involves complex multi-stage evacuation and resuscitation for severely injured battlefield patients. This approach addresses unique challenges in combat zones to prevent the lethal triad of hypothermia, acidosis, and coagulopathy.

Area of Science:

  • Trauma Surgery
  • Military Medicine
  • Surgical Critical Care

Background:

  • Damage control surgery is established for civilian blunt and penetrating injuries.
  • The battlefield application of damage control surgery remains less detailed.
  • Civilian damage control surgery utilizes a trilogy of abbreviated operation, ICU resuscitation, and definitive surgery.

Purpose of the Study:

  • To detail the unique aspects of combat damage control surgery.
  • To compare the combat paradigm with the established civilian model.
  • To highlight the challenges faced in managing severely injured combat patients.

Main Methods:

  • The study defines the civilian damage control paradigm and its goals.
  • It contrasts the civilian model with the combat damage control paradigm.

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  • It outlines the multi-stage process required for battlefield care and evacuation.

    • Main Results:

    • The civilian damage control trilogy aims to prevent the lethal triad (hypothermia, acidosis, coagulopathy).
    • The combat damage control paradigm necessitates global evacuation through multiple facilities.
    • Combat damage control involves up to ten stages, including evacuation, surgery, and resuscitation.

    Conclusions:

    • Combat damage control surgery presents distinct challenges compared to civilian settings.
    • The combat model must accommodate extensive logistical requirements for patient transport and care.
    • Effective management of severely injured patients in combat zones requires specialized approaches.