Abstract
The concept of damage control resuscitation encompasses multiple phases of care: the prehospital and trauma bay resuscitation (DC 0), the initial surgical exploration via laparotomy, thoracotomy, or sternotomy with exsanguination and contamination control (DC I) and further resuscitation within the surgical intensive care unit (DC II). All of this leads up to definitive organ repair and abdominal closure, termed damage control phase III (DC III). Timing of this particular stage is critical as it will likely have the most impact on achieving traditional measures of “successful outcomes” (e.g.- hospital length of stay, surgical site infections, anastomotic leaks, etc.). Prior to transitioning to DC III, the team should ensure that adequate resuscitation and physiological optimization has been achieved; i.e.; normothermic, normal coagulation studies as well as a normal pH and lactate. With focused, aggressive critical care management and resuscitation one may obtain this physiologic state within 24–36 h.1,2
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsReferences
Rotondo MF, Schwab CW, McGonigal MD, et al. “Damage Control”: an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma. 1993;35:375-382.
Johnson JW et al. Evolution in damage control for exsanguinating penetrating abdominal injury. J Trauma. 2001;51(2):261-269. discussion 269-271.
Hadeed JG et al. Delayed primary closure in damage control laparotomy: the value of the Wittmann patch. Am Surg. 2007;73(1):10-12.
Rowlands BJ, Flynn TC, Fischer RP. Temporary abdominal wound closure with a silastic “chimney”. Contemp Surg. 1984;24:17-20.
Livingston DH, Sharma PK, Glantz AI. Tissue expanders for abdominal wall reconstruction following severe trauma: technical note and case reports. J Trauma. 2002;32:82-86.
Wall MJ Jr et al. Pulmonary tractotomy as an abbreviated thoracotomy technique. J Trauma. 1998;45(6):1015-1023.
Wall MJ Jr, Soltero E. Damage control for thoracic injuries. Surg Clin North Am. 1997;77(4):863-878.
Feliciano D, Accola KD, Burch JM, Spjut-Patrinely V. Extraanatomic bypass for peripheral arterial injuries. Am J Surg. 1989;158:506-510.
Subramanian A, Vercruysse G, Dente C, Wyrzykowski A, King E, Feliciano DV. A decade’s experience with temporary intravascular shunts at a civilian level I trauma center. J Trauma. 2008;65(2):316-326.
Bowley DM et al. Evolving concepts in the management of colonic injury. Injury. 2001;32(6):435-439.
Brundage SI et al. Stapled versus sutured gastrointestinal anastomoses in the trauma patient. J Trauma. 1999;47(3):500-507. Discussion 507-508.
Brundage SI et al. Stapled versus sutured gastrointestinal anastomoses in the trauma patient: a multicenter trial. J Trauma. 2001;51(6):1054-1061.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2011 Springer London
About this chapter
Cite this chapter
Allen, S.R., Brooks, A.J., Reilly, P.M., Cotton, B.A. (2011). Damage Control Part III: Definitive Reconstruction. In: Brooks, A., Clasper, J., Midwinter, M., Hodgetts, T., Mahoney, P. (eds) Ryan's Ballistic Trauma. Springer, London. https://doi.org/10.1007/978-1-84882-124-8_31
Download citation
DOI: https://doi.org/10.1007/978-1-84882-124-8_31
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-84882-123-1
Online ISBN: 978-1-84882-124-8
eBook Packages: MedicineMedicine (R0)