The Damage Control Approach

  • Claudia E. Goettler
  • Michael F. Rotondo
  • Peter V. Giannoudis

“Trauma surgery is just general surgery, but faster and under blood.” – Anonymous As the majority of trauma resuscitation and operation was historically performed by general surgeons, the practice of trauma and surgical critical care developed slowly as a general surgical subspecialty by those with special interest in this patient population. Surgical procedures for injury care, therefore, have been based entirely on elective general surgical procedures. Hence, injury to the stomach would receive an operative approach similar to that of a perforated ulcer. This was gradually modified by war experiences. Patients from the war zone generally had massive destructive wounds, and there was also delay to definitive care. This resulted in the development of novel operative techniques for trauma, such as pyloric exclusion, which are gradually finding their way back into general surgery for severe diseases.


Abdominal Compartment Syndrome Damage Control Abdominal Closure Temporary Abdominal Closure Trauma Resuscitation 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Stone HH, Strom PR, Mullins RJ Management of the major coagulopathy with onset during laparotomy. Ann Surg 1983; 197: 532–535.CrossRefPubMedGoogle Scholar
  2. 2.
    Burch JM, Ortiz VB, Richardson RJ, Martin RR, Mattox KL, Jordan GL Abbreviated laparotomy and planned reoperation for critically injured patients. Ann Surg 1992; 215: 476–484.CrossRefPubMedGoogle Scholar
  3. 3.
    Rotondo MF, Schwab CW, McGonigal MD, Phillips, III, GR, Fruchterman TM, Kauder DR, Latenser BA, Angood PA “Damage control”: An approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 1993; 3: 375–382.CrossRefPubMedGoogle Scholar
  4. 4.
    Sagraves SG, Rotondo MF, Toschlog EA, Schenarts PJ, Bard MR, Goettler CE Brief interval transfer (BIT): The morbid consequence of delay to the trauma center in a rural patient demographic (abstract). J Trauma 2002; 53(6): 1209.Google Scholar
  5. 5.
    Morris JA, Eddy VA, Blirman TA, Rutheford EJ, Sharp EW The staged celiotomy for trauma: Issues in unpacking and reconstruction. Ann Surg 1993; 217: 576–586.CrossRefPubMedGoogle Scholar
  6. 6.
    Cué JI, Cryer HG, Miller FB, Richardson JD, Polk HC Jr. Packing and planned reexploration for hepatic and retroperitoneal hemorrhage: Critical refinements of a useful technique. J Trauma 1990; 30: 1007–1013.CrossRefPubMedGoogle Scholar
  7. 7.
    Reilly PM, Rotondo MF, Carpenter JP, Sherr SA, Schwab CW Temporary vascular continuity during damage control: Intraluminal shunting of proximal superior mesenteric artery injury. J Trauma 1995; 39(4): 757–760.CrossRefPubMedGoogle Scholar
  8. 8.
    Porter JM, Ivatury RR, Nassoura ZE Extending the horizons of “damage control” in unstable trauma patients beyond the abdomen and gastrointestinal tract. J Trauma 1997; 42(3): 559–561.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Claudia E. Goettler
    • 1
  • Michael F. Rotondo
  • Peter V. Giannoudis
  1. 1.Department of Surgery, Brody School of MedicineEast Carolina UniversityGreenvilleUSA

Personalised recommendations