Damage Control and Immediate Resuscitation for Vascular Trauma

Abdominal vascular trauma occurs in a small proportion of patients admitted in trauma centers. However, up to a quarter or a third of the patients who require a laparotomy will have a vascular injury. Preoperative identification is impossible in most cases, therefore, surgeons must be prepared for its early intraoperative recognition to allow appropriate management. This include temporary bleeding control techniques, identification of the probable injured vessel and the specific approach and management. Often, recognition of exsanguinating intra-abdominal hemorrhage will lead to immediate surgical indication, with activation of damage control protocols and consideration of early aortic occlusion.This paper illustrates the applications of damage control in the management of patients with abdominal vascular trauma.

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Use of endovascular balloons may simplify the proximal and distal control in complicated vascular trauma.

Journal of Endovascular Resuscitation and Trauma Management ◽

10.26676/jevtm.v1i1.5 ◽

2017 ◽

Vol 1 (1) ◽

pp. 39-41

Author(s):

Offer Galili

Keyword(s):

Damage Control ◽

Vascular Trauma ◽

Balloon Occlusion ◽

Control Measures ◽

Case Presentation ◽

Simplified Approach ◽

Management Concepts ◽

Novel Strategy ◽

Anatomic Locations ◽

Control Management

The treatment of vascular injuries remains a significant challenge of modern trauma care. This is particularly true of injuries at challenging anatomic locations or that are complex in nature. The mortality rates from these injuries can be high, despite recent progress in application of damage control management concepts. Developments of endovascular techniques have introduced new alternatives to traditional open repair strategies that may prove useful in the setting of complex vascular injury. The concept of endovascular and hybrid trauma management (EVTM) gains experience which allows replacing traditional principles of open vascular management in selected cases. Endovascular modalities, specifically intra-vascular balloon occlusion, offer a novel strategy that may be of particular use in these situations. Our present case presentation outlines an example of successful utilization of this approach and affords an opportunity to review a simplified approach using endovascular balloons as proximal and distal control measures, in order to limit the challenges represented by more extensive anatomic exposures in a victim of trauma.

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Damage Control for Vascular Trauma from the Prehospital to the Operating Room Setting

Frontiers in Surgery ◽

10.3389/fsurg.2017.00073 ◽

2017 ◽

Vol 4 ◽

Cited By ~ 2

Author(s):

Emmanouil Pikoulis ◽

Karim M. Salem ◽

Efthymios D. Avgerinos ◽

Anastasia Pikouli ◽

Anastasios Angelou ◽

...

Keyword(s):

Operating Room ◽

Damage Control ◽

Vascular Trauma

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To Shunt or Not to Shunt? An Experimental Study Comparing Temporary Vascular Shunts and Venous Ligation as Damage Control Techniques for Vascular Trauma

Annals of Vascular Surgery ◽

10.1016/j.avsg.2013.10.005 ◽

2014 ◽

Vol 28 (3) ◽

pp. 710-724 ◽

Cited By ~ 8

Author(s):

Adenauer Marinho de Oliveira Góes Junior ◽

Simone de Campos Vieira Abib ◽

Maria Teresa de Seixas Alves ◽

Paulo Sérgio Venerando da Silva Ferreira ◽

Mariseth Carvalho de Andrade

Keyword(s):

Experimental Study ◽

Damage Control ◽

Vascular Trauma ◽

Control Techniques

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Damage Control and Immediate Resuscitation for Vascular Trauma

Rich's Vascular Trauma ◽

10.1016/b978-1-4557-1261-8.00007-2 ◽

2016 ◽

pp. 56-63

Author(s):

Timothy Hodgetts

Keyword(s):

Damage Control ◽

Vascular Trauma

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Damage control of peripheral vascular trauma - Don’t be afraid of axillary or popliteal fosses

Colombia Medica ◽

10.25100/cm.v52i2.4735 ◽

2021 ◽

Vol 52 (2) ◽

pp. e4114735

Author(s):

Mario Alain Herrera ◽

Mauricio Millan ◽

Ana Milena Del Valle ◽

Mateo Betancourt-Cajiao ◽

Yaset Caicedo ◽

...

Keyword(s):

Vascular Injury ◽

Primary Repair ◽

Damage Control ◽

Damage Control Surgery ◽

Vascular Trauma ◽

Surgical Approaches ◽

Peripheral Vascular ◽

Limb Perfusion ◽

Injured Region ◽

Definitive Repair

Peripheral vascular injuries are uncommon in civilian trauma but can threaten the patient’s life or the viability of the limb. The definitive control of the vascular injury represents a surgical challenge, especially if the patient is hemodynamically unstable. This article proposes the management of peripheral vascular trauma following damage control surgery principles. It is essential to rapidly identify vascular injury signs and perform temporary bleeding control maneuvers. The surgical approaches according to the anatomical injured region should be selected. We propose two novel approaches to access the axillary and popliteal zones. The priority should be to reestablish limb perfusion via primary repair or damage control techniques (vascular shunt or endovascular approach). Major vascular surgeries should be managed postoperatively in the intensive care unit, which will allow correction of physiological derangement and identification of those developing compartmental syndrome. All permanent or temporary vascular procedures should be followed by a definitive repair within the first 8 hours. An early diagnosis and opportune intervention are fundamental to preserve the function and perfusion of the extremity.

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