Damage control in abdominal vascular trauma

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Surgical Critical Care

Background:

• Vascular injuries complicate up to one-third of abdominal trauma laparotomies.
• Commonly injured vessels include the vena cava, iliac veins, iliac arteries, and aorta.

Purpose of the Study:

• To outline a surgical approach for abdominal vascular trauma using damage control principles.
• To emphasize expeditious hemorrhage control and contamination management.

Main Methods:

• Initial hemorrhage control via pressure, clamping, and packing.
• Identification of compromised vascular structures based on hematoma location.
• Temporary management strategies including ligation, transient bypass, and packing.

Main Results:

• Focus on achieving temporary bleeding control and minimizing contamination.
• Postponement of definitive vascular repair until hemodynamic stability and coagulopathy correction.
• Use of unconventional abdominal closure, such as negative pressure systems, to facilitate reoperation.

Conclusions:

• Damage control principles are crucial for managing abdominal vascular trauma.
• Temporary measures allow for patient resuscitation before definitive surgical intervention.
• This strategy aims to improve outcomes in critically injured patients.