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Damage control surgery: it's evolution over the last 20 years.

Brett H Waibel1, Michael M F Rotondo

  • 1brett.waibel@vidanthealth.com

Revista Do Colegio Brasileiro De Cirurgioes
|September 1, 2012
PubMed
Summary
This summary is machine-generated.

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Damage control resuscitation, a treatment model for critical surgical conditions, has evolved significantly. It now improves survival rates for previously lethal injuries by focusing on staged surgical intervention and advanced resuscitation techniques.

Area of Science:

  • Surgical Critical Care
  • Trauma Surgery
  • Emergency Medicine

Background:

  • Damage control surgery (DCS) evolved from treating exsanguinating trauma patients.
  • It addresses emergent surgical conditions unsuitable for traditional methods.
  • The model involves staged intervention and intensive resuscitation.

Purpose of the Study:

  • To describe the evolution and application of the damage control paradigm.
  • To highlight advancements in resuscitation strategies supporting DCS.
  • To assess the impact of DCS on previously unsurvivable injuries.

Main Methods:

  • The study reviews the core principles of DCS: patient selection, abbreviated surgery, ICU resuscitation, and delayed definitive care.
  • It discusses the integration of new resuscitation strategies like permissive hypotension and damage control resuscitation (DCR).

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  • Technological advancements in ventilation and hemostasis are considered.

    • Main Results:

    • DCS has expanded beyond trauma to treat conditions like septic abdomen and orthopedic emergencies.
    • Advances in resuscitation have reduced the morbidity associated with DCS.
    • The combination of DCS principles and improved resuscitation has increased survival rates for severe injuries.

    Conclusions:

    • The damage control paradigm, combined with enhanced resuscitation, has transformed the management of critical surgical emergencies.
    • Previously lethal injuries, such as combined vascular and visceral trauma, are now survivable.
    • This approach represents a significant advancement in surgical critical care.