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Damage control surgery in lung trauma.

Alberto García1,2,3, Mauricio Millán3,4, Carlos A Ordoñez1,2,3

  • 1Universidad del Valle, Facultad de Salud, Escuela de Medicina, Department of Surgery, Division of Trauma and Acute Care Surgery, Cali, Colombia.

Colombia Medica (Cali, Colombia)
|June 30, 2021
PubMed
Summary

Damage control thoracotomy is a critical abbreviated surgical procedure for severe thoracic injuries. It involves temporary bleeding control and definitive management in the intensive care unit, improving patient outcomes.

Keywords:
Damage control surgeryballoon occlusioncardiac outputchest tubesheart arresthemostasishemostaticshemothoraxlung injurypneumonectomysternotomythoracotomy

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Area of Science:

  • Trauma Surgery
  • Thoracic Surgery
  • Surgical Critical Care

Background:

  • Damage control techniques for thoracic injuries have advanced over 15 years.
  • Limited publications exist, but management principles are emerging.
  • Indications are based on anatomical injury severity and physiological derangement.

Purpose of the Study:

  • Establish management principles for damage control in thoracic trauma.
  • Define indications for damage control thoracotomy.
  • Outline strategies for transient bleeding control and definitive management.

Main Methods:

  • Classification of lung injuries (peripheral, transfixing, central, multiple).
  • Identification of specific patterns indicating damage control thoracotomy (e.g., massive hemothorax, tracheobronchial injury, coagulopathy).
  • Abbreviated surgical procedures including packing, selective hilum clamping, and modified closure.

Main Results:

  • Damage control thoracotomy is indicated in selected cases with severe physiological derangement or specific injury patterns.
  • The procedure involves temporary measures like packing and delayed definitive repair.
  • Postoperative intensive care unit management is crucial for reintervention and correction of derangements.

Conclusions:

  • Damage control thoracotomy is a valuable strategy for specific, severe thoracic injuries.
  • Classification of lung injuries guides transient and definitive management.
  • Effective postoperative care is essential for successful outcomes.