Damage Control in Surgery

  • D. Demetriades
  • K. Inaba
  • P. Talving


Damage control surgery is considered by many surgeons as one of the most significant advances in the last 2 decades in the care of trauma or other surgical patients with severe hemorrhage, which cannot easily be controlled by other techniques. In the recent wars in Iraq and Afghanistan this approach has been used extensively and has been credited with saving many lives [1]. The present chapter reviews the history, indications, techniques, controversies, complications, and outcomes for damage control procedures.


Pelvic Fracture Abdominal Compartment Syndrome Damage Control Tight Packing Damage Control Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Blackbourne LH (2008) Combat damage control surgery. Crit Care Med 36:S304–310CrossRefGoogle Scholar
  2. 2.
    Rotondo MF, Schwab CW, McGonigal MD et al (1993) “Damage control”: An approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma 35:375–383PubMedGoogle Scholar
  3. 3.
    Rotondo MF, Bard MR (2004) Damage control surgery for thoracic injuries. Injury 35:649–654CrossRefPubMedGoogle Scholar
  4. 4.
    Rosenfeld JV (2004) Damage control neurosurgery. Injury 35:655–660CrossRefPubMedGoogle Scholar
  5. 5.
    Hildebrand F, Giannoudis P, Kretteck C et al (2004) Damage control: Extremities. Injury 35:678–689CrossRefPubMedGoogle Scholar
  6. 6.
    Teixeira P, Salim A, Inaba K et al (2008) A prospective look at the current state of open abdomens. Am Surg 74:891–897PubMedGoogle Scholar
  7. 7.
    Jurkovich GJ, Greiser WB, Luterman A (1977) Hypothermia in trauma victims: An ominous predictor of survival. J Trauma 27:1019–1024Google Scholar
  8. 8.
    Centilello LM, Jurkovich GJ, Stark MS et al (1997) Is hypothermia in the victim of major trauma protective or harmful? A randomized, prospective study. Ann Surg 226:447–449Google Scholar
  9. 9.
    Shafi S, Elliott AC, Gentilello L (2005) Is hypothermia simply a marker of shock and injury severity or an independent risk factor for mortality in trauma patients? Analysis of a large national trauma registry. J Trauma 59:1081–1085CrossRefPubMedGoogle Scholar
  10. 10.
    Lier H, Krep H, Schroeder S, Stuber F (2008) Preconditions of hemostasis in trauma: A review. The influence of acidosis, hypocalcemia, anemia, and hypothermia on functional hemostasis in trauma. J Trauma 65:951–960CrossRefPubMedGoogle Scholar
  11. 11.
    Watts DD, Trask A, Soeken K et al (1998) Hypothermic coagulopathy in trauma: Effect of varying levels of hypothermia on enzyme speed, platelet function, and fibrinolytic activity. J Trauma 44:846–854CrossRefPubMedGoogle Scholar
  12. 12.
    Johnston TD, Chen Y, Reed RL (1994) Functional equivalence of hypothermia to specific clotting factor deficiencies. J Trauma 37:413–417CrossRefPubMedGoogle Scholar
  13. 13.
    Hoffman M (2004) The cellular basis of traumatic bleeding. Mil Med 169:5–7PubMedGoogle Scholar
  14. 14.
    Martini WZ, Dubick MA, Pusateri AE (2006) Does bicarbonate correct coagulation function impaired by acidosis in swine? J Trauma 61:99–106CrossRefPubMedGoogle Scholar
  15. 15.
    Hirshberg A, Wall MJ, Mattox KL (1994) Planned reoperation for trauma: A two year experience with 124 consecutive patients. J Trauma 37:365–369PubMedCrossRefGoogle Scholar
  16. 16.
    Offner PJ, de Souza, AL, Moore EE et al (2001) Avoidance of abdominal compartment syndrome in damage-control laparotomy after trauma. Arch Surg 136:676–681CrossRefPubMedGoogle Scholar
  17. 17.
    Raeburn CD, Moore EE, Biffl WL (2001) The abdominal compartment syndrome is a morbid complication of post injury damage control. Am J Surg 182:542–546CrossRefPubMedGoogle Scholar
  18. 18.
    Gilroy D, Lakhoo M, Charalambides D, Demetriades D (1992) Control of life-threatening hemorrhage from the neck: a new indication for balloon tamponade. Injury 23:557–559CrossRefPubMedGoogle Scholar
  19. 19.
    Thomas SV, Dulchavsky SA, Diebel LN (1993) Balloon tamponade for liver injuries: Case report. J Trauma 34:448–449CrossRefPubMedGoogle Scholar
  20. 20.
    Demetriades D (1988) Balloon tamponade for bleeding control in penetrating liver injuries. J Trauma 44:538–539CrossRefGoogle Scholar
  21. 21.
    Cothren CC, Osborn PM, Moore EE et al (2007) Preperitoneal pelvic packing for hemodynamically unstable pelvic fractures: A paradigm shift. J Trauma 62:834–839CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia 2009

Authors and Affiliations

  • D. Demetriades
    • 1
  • K. Inaba
    • 2
  • P. Talving
    • 3
  1. 1.Trauma and Surgical Intensive Care UnitUniversity of Southern CaliforniaLos AngelesUSA
  2. 2.Surgical Critical Care Fellowship ProgramUniversity of Southern CaliforniaLos AngelesUSA
  3. 3.University of Southern CaliforniaLos AngelesUSA

Personalised recommendations