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Damage control surgery

2004; Elsevier BV; Volume: 20; Issue: 1 Linguagem: Inglês

10.1016/s0749-0704(03)00095-2

1557-8232

Martin A. Schreiber,

Trauma, Hemostasis, Coagulopathy, Resuscitation

Damage control surgery is defined as rapid termination of an operation after control of life-threatening bleeding and contamination followed by correction of physiologic abnormalities and definitive management. This modern strategy involves a staged approach to multiply injured patients designed to avoid or correct the lethal triad of hypothermia, acidosis, and coagulopathy before definitive management of injuries. It is applicable to a wide variety of disciplines. During the first stage of damage control, hemorrhage is stopped, and contamination is controlled using the simplest and most rapid means available. Temporary wound closure methods are employed. The second stage is characterized by correction of physiologic abnormalities in the ICU. Patients are warmed and resuscitated, and coagulation defects are corrected. In the final phase of damage control, definitive operative management is completed in a stable patient.