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Damage control surgery can be divided into the following three phases: Initial laparotomy, Intensive Care Unit (ICU) resuscitation, and definitive reconstruction. Each of these phases has defined timing and objectives to ensure best outcomes. The following goes through the different phases to illustrate, step by step, how one might approach this.
A philosophy of damage control orthopaedics (DCO) was proposed in 2000, [2] aiming to prevent early death in a critically wounded patient via stabilization and not definitive fixation, often with the use of external fixation systems. EAC was developed by Heather Vallier while at MetroHealth in Cleveland. [3]
These ICU transport capabilities allowed trauma surgeons to perform far forward damage control surgery, knowing that these patients could be quickly transported rearward. Combined with other advances in field medical care, what resulted is the lowest died of wounds rate measured in modern times (testimony House Armed Services Committee, 2005 ...
Trauma surgery is a surgical specialty that utilizes both operative and non-operative management to treat traumatic injuries, typically in an acute setting. Trauma surgeons generally complete residency training in general surgery [ 1 ] [ 2 ] and often fellowship training in trauma or surgical critical care .
In severe liver injuries (class ≥III), or those with hemodynamic instability, surgery is generally necessary. [7] Surgical techniques such as perihepatic packing or the use of the Pringle manoeuvre can be used to control hemorrhage. [2] [3] Temporary control of the hemorrhage can be accomplished through direct manual pressure to the wound ...
Similar failure processes are involved in brain failure following reversal of cardiac arrest; [3] control of these processes is the subject of ongoing research. Repeated bouts of ischemia and reperfusion injury also are thought to be a factor leading to the formation and failure to heal of chronic wounds such as pressure sores and diabetic foot ...
As an enemy is suppressed, casualties can move or be moved to more secure positions. The only medical treatment rendered in CUF is stopping life-threatening hemorrhaging (bleeding). TCCC actively endorses and recommends the early and immediate use of tourniquets to control massive external hemorrhaging of limbs.
Surgical packing of the wounds is generally not the favored technique to control bleeding as it can be less useful than fixing the directly affected organs. [18] In severe cases when homeostasis cannot be maintained the use of damage control surgery may be utilized. [19]