scholarly journals The Evolution of Damage Control in Concept and Practice

2017 ◽  
Vol 31 (01) ◽  
pp. 030-035 ◽  
Author(s):  
Brian Beldowicz
Keyword(s):  
Medical Decision Making ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Strategy Implementation ◽  
Medical Decision ◽  
Metabolic Dysfunction ◽  
Damage Control Resuscitation ◽  
Hemorrhage Control ◽  
Threat To Life ◽  
Critically Ill Surgical Patients

AbstractDamage control surgery (DCS) began as an adjunct approach to hemorrhage control, seeking to facilitate the body's innate clotting ability when direct repair or ligation was impossible, but it has since become a valuable instrument for a broader collection of critically ill surgical patients in whom metabolic dysfunction is the more immediate threat to life than imminent exsanguination. Modern damage control is a strategy that combines the principles of DCS with those of damage control resuscitation. When used correctly, damage control may improve survival in previously unsalvageable patients; when used incorrectly, it can subject patients to imprudent risk and contribute to morbidity. This review discusses the evolution of damage control in both concept and practice, summarizing available literature and experience to guide patient selection, medical decision-making, and strategy implementation throughout the preoperative, intraoperative, and early postoperative periods.

Operative Exposure of Abdominal Injuries and Closure of the Abdomen

2019 ◽  
Author(s):  
Matthew D Nealeigh ◽  
Mark W Bowyer
Keyword(s):  
Open Abdomen ◽  
Nonoperative Management ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Damage Control Resuscitation ◽  
Abdominal Injuries ◽  
Penetrating Injuries ◽  
Optimal Outcomes ◽  
Medial Rotation ◽  
Selective Nonoperative Management

Operative exposure and management of significant blunt or penetrating injuries to the abdomen is a critical skill required of all surgeons caring for victims of trauma. Application of damage control resuscitation and damage control surgical principles improves survival. Advances in diagnostics, increasing experience with selective nonoperative management, and use of endovascular and angiographic techniques have all significantly decreased the frequency of laparotomies performed for trauma. This decreasing clinical experience mandates that surgeons dealing with victims of trauma remain facile with the operative approaches and techniques detailed in this chapter to achieve optimal outcomes. Detailed management of specific injuries is covered in other chapters of this text. This review contains 7 figures, 2 tables, and 41 references.  Key Words: abdominal trauma, damage control resuscitation, damage control surgery, endovascular control of hemorrhage, open abdomen, REBOA, supraceliac control of aorta, trauma systems, visceral medial rotation

Damage Control Surgery in the Era of Damage Control Resuscitation

2015 ◽  
Vol 59 (3) ◽  
pp. 114-115
Author(s):  
C. M. Lamb ◽  
P. MacGoey ◽  
A. P. Navarro ◽  
A. J. Brooks
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Damage Control Resuscitation

Massive Transfusion in a Child

2013 ◽  
Author(s):  
Stefan Sabato
Keyword(s):  
Direct Evidence ◽  
Massive Transfusion ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Supporting Evidence ◽  
Damage Control Resuscitation ◽  
Acute Hemorrhage ◽  
Early Management ◽  
Major Morbidity ◽  
The Core

The traditional early management of hemorrhagic shock is currently being challenged, and many centers around the world have already changed their practice. Damage-control resuscitation, in conjunction with damage-control surgery, has been shown to improve major morbidity and mortality outcomes in adults. In children there is little direct evidence for these new approaches, but supporting evidence is accumulating. This chapter will introduce these concepts while also reinforcing the core principles of managing acute hemorrhage in the trauma setting.

Critical Care Considerations for Damage Control in a Trauma Patient

2021 ◽  
Vol 32 (1) ◽  
pp. 64-75
Author(s):  
Shannon Gaasch
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cause Of Death ◽  
Damage Control ◽  
Operative Procedure ◽  
Fixed Ratio ◽  
Damage Control Surgery ◽  
Fluid Restriction ◽  
Damage Control Resuscitation ◽  
Lethal Triad

Traumatic injury remains the leading cause of death among individuals younger than age 45 years. Hemorrhage is the primary preventable cause of death in trauma patients. Management of hemorrhage focuses on rapidly controlling bleeding and addressing the lethal triad of hypothermia, acidosis, and coagulopathy. The principles of damage control surgery are rapid control of hemorrhage, temporary control of contamination, resuscitation in the intensive care unit to restore normal physiology, and a planned, delayed definitive operative procedure. Damage control resuscitation focuses on 3 key components: fluid restriction, permissive hypotension, and fixed-ratio transfusion. Rapid recognition and control of hemorrhage and implementation of resuscitation strategies to control damage have significantly improved mortality and morbidity rates. In addition to describing the basic principles of damage control surgery and damage control resuscitation, this article explains specific management considerations for and potential complications in patients undergoing damage control interventions in an intensive care unit.

scholarly journals Damage control surgery in the era of damage control resuscitation

2014 ◽  
Vol 113 (2) ◽  
pp. 242-249 ◽  
Author(s):  
C.M. Lamb ◽  
P. MacGoey ◽  
A.P. Navarro ◽  
A.J. Brooks
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Damage Control Resuscitation

scholarly journals Resusitasi Pengendalian Kerusakan Di Unit Perawatan Intensif

2021 ◽  
Vol 36 (2) ◽  
pp. 71-75
Author(s):  
Dhanu Pitra Arianto ◽  
Nurita Dian Kestriani
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Massive Bleeding ◽  
Trauma Patients ◽  
Damage Control Resuscitation ◽  
Early Management ◽  
Severe Haemorrhage ◽  
Lethal Triad ◽  
Clotting Cascade ◽  
Injured Patients

Abstrak Resusitasi dengan pengendalian kerusakanmenggambarkan suatu pendekatan ke perawatan awal pada pasien dengan cedera berat. Tujuan pendekatan ini untuk menjaga pasien tetap stabil dengan menghindari intervensi dan kondisi yang berisiko kepada keadaan perburukan dengan mengendalikan trias kematian, yaitu hipotermia, koagulopati, dan asidosis. Merupakan hal yang penting bahwa konsep dan kepraktisan pendekatan ini dipahami oleh semua yang terlibat dalam manajemen awal pasien trauma. Pendekatan ini dimulai dengan pemberian produk darah sejak awal, penghentian perdarahan dan pengembalian volume darah yang bertujuan untuk mengembalikan stabilitas fisiologis dengan cepat. Resusitasi dengan pengendalian kerusakan memilikibeberapa tambahan pendekatan dari bidang farmakologis dan laboratorium untuk meningkatkan perawatan pasien yang mengalami perdarahan. Pendekatan ini termasuk trombelastografi sebagai ukuran rinci kaskade pembekuan, asam traneksamat sebagai antifibrinolitik.   Kata kunci : hipotermia, koagulopati, asidosis, perdarahan masif     Damage Control Resuscitation in Intensive Care Unit   Abstract Damage control resuscitation (DCR) describes an approach to the early care of very seriously injured patients. The aim is to keep the patient alive whilst avoiding interventions and situations that risk worsening their situation by driving the lethal triad of hypothermia, coagulopathy and acidosis.It is critical that the concepts and practicalities of this approach are understood by all those involved in the early management of trauma patients. Damage control resuscitation forms part of an overall approach to patient care rather than a specific intervention and has evolved from damage control surgery. It is characterised by early blood product administration, haemorrhage arrest and restoration of blood volume aiming to rapidly restore physiologic stability. The infusion of large volumes of crystalloid is no longer appropriate, instead the aim is to replace lost blood and avoid dilution and coagulopathy. In specific situations, permissive hypotension may also be of benefit, particularly in patients with severe haemorrhage from an arterial source. Damage control resuscitation has been augmented by both pharmacologic and laboratory adjuncts to improve the care of the hemorrhaging patient. These include thrombelastography as a detailed measure of the clotting cascade, tranexamic acid as an antifibrinolytic.   Keywords: hypothermia, coagulopathy, acidosis, massive bleeding

scholarly journals Damage Control Surgery for the Management of Major Obstetric Hemorrhage: Experience from the Fundación Valle Del Lili, Cali, Colombia

2017 ◽  
Vol 6 (1) ◽  
pp. 1-7 ◽  
Author(s):  
Carlos A Ordóñez ◽  
Albaro J Nieto ◽  
Javier A Carvajal ◽  
Juan M Burgos ◽  
Adriana Messa ◽  
...  
Keyword(s):  
Damage Control ◽  
Case Series ◽  
Damage Control Surgery ◽  
Descriptive Study ◽  
Clinical Severity ◽  
Damage Control Resuscitation ◽  
Obstetric Hemorrhage ◽  
Rapid Control ◽  
Expected Mortality ◽  
Overall Mortality

ABSTRACT Objective The aim of this case series is to describe the experience of implementing damage control resuscitation (DCR) in patients with major obstetric hemorrhage (MOH) between January 2005 and December 2015 in the Fundación Valle del Lili, Cali, Colombia. Materials and methods This is a prospective descriptive study of a case series from 108 patients with MOH who were subjected to DCR. All patients were operated on using a standardized surgical technique in accordance with the institutional protocol. Results The median age was 28 years, with a gestational age of 38 weeks. The principal associated diagnosis was severe preeclampsia (in 39% of cases). A total of 96 patients presented massive postpartum hemorrhage, and 75% of these cases presented after a cesarean section. In all patients, normal control of bleeding was achieved, 60% during the first surgical period. The Acute Physiology and Chronic Health Evaluation score was 14, with an overall mortality of 6.48%, far below the expected mortality according to the clinical severity of these patients. Conclusion This study includes the biggest series of pregnant women with MOH, in a critical condition, in whom DCR was used, during which rapid control of bleeding was achieved, associated with a significantly lower mortality than expected. How to cite this article Escobar MF, Carvajal JA, Burgos JM, Messa A, Ordoñez CA, García AF, Granados M, Forero AM, Casallas JD, Thomas LS, Nieto AJ. Damage Control Surgery for the Management of Major Obstetric Hemorrhage: Experience from the Fundación Valle Del Lili, Cali, Colombia. Panam J Trauma Crit Care Emerg Surg 2017;6(1):1-7.

The role of the operating department practitioner on board Role 2 Afloat

2017 ◽  
Vol 103 (1) ◽  
pp. 30-31
Author(s):  
A Stables ◽  
G Seal ◽  
S J Mercer
Keyword(s):  
Damage Control ◽  
Damage Control Surgery ◽  
Damage Control Resuscitation ◽  
Royal Navy

AbstractThe Role 2 Afloat (R2A) is the Royal Navy (RN)’s Damage Control Resuscitation (DCR), including Damage Control Surgery, capability at sea. There are currently three operating department practitioners (ODP) in the deployed team. This article describes the role of the ODP in this team and the training which is required to fulfil this role.

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