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Damage Control Surgery

  • Elizabeth Benjamin
  • Kenji Inaba
  • Demetrios Demetriades
Chapter

Abstract

Damage control is a combination of surgical techniques and damage control resuscitation. It can be performed in injuries involving the abdomen, chest, neck, vessels, bones, and soft tissues. It should be considered in patients with persistent bleeding and limited physiological reserve, in austere environments with limited resources, and in bleeding from anatomically difficult areas. It is a three-stage approach and involves temporary control of bleeding by packing, vascular shunting, or ligation and control of intestinal spillage in the operating room (first stage), physiological stabilization in the intensive care unit (second stage), and semi-elective definitive repair of all injuries in the operating room (third stage).

Damage control should be considered early, before major physiological decompensation. The timing of damage control should be determined by several factors including the type, anatomical site, and severity of injuries; the physiological condition, age and co-morbidities of the patient; the experience of the surgeon; and the available resources. Angio-embolization in the appropriate cases may be a useful adjunct to damage control procedures. This chapter reviews the indications, techniques, controversies, complications, and outcomes for damage control procedures in trauma.

Keywords

Damage control surgery Temporary abdominal closure Damage control resuscitation Hemorrhage 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Elizabeth Benjamin
    • 1
  • Kenji Inaba
    • 1
  • Demetrios Demetriades
    • 1
  1. 1.Department of Surgery, LAC+USC Medical CenterLos AngelesUSA

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