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Damage control in abdominal vascular trauma.

Alberto García1,2,3, Mauricio Millán3,4, Daniela Burbano5

  • 1Fundación Valle del Lili. Department of Surgery. Division of Trauma and Acute Care Surgery, Cali, Colombia. Fundación Valle del Lili Department of Surgery Division of Trauma and Acute Care Surgery Cali Colombia.

Colombia Medica (Cali, Colombia)
|January 14, 2022
PubMed
Summary

Damage control surgery for abdominal vascular trauma prioritizes immediate bleeding control over definitive repair. This approach involves temporary measures and delayed definitive management after patient stabilization.

Keywords:
Vascular system injuriesamputationanastomosis, surgicalaorta, abdominalcompartment syndromesdissectionfemoral veinhematomahemodynamicsischemialaparotomymesenteric artery, superiormesenteric veinsperitoneal cavityportal veinrenal veinsreperfusionvena cava, inferiorviscera

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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.