• Curr Opin Crit Care · Dec 2023

    Review

    Damage control surgery: old concepts and new indications.

    • C Yvonne Chung and Thomas M Scalea.
    • R Adams Cowley Shock Trauma Center, University of Maryland Medical System, Baltimore, Maryland.
    • Curr Opin Crit Care. 2023 Dec 1; 29 (6): 666673666-673.

    Purpose Of ReviewWhile the principles of damage control surgery - rapid hemorrhage and contamination control with correction of physiologic derangements followed by delayed definitive reconstruction - have remained consistent, forms of damage control intervention have evolved and proliferated dramatically. This review aims to provide a historic perspective of the early trends of damage control surgery as well as an updated understanding of its current state and future trends.Recent FindingsPhysiologically depleted patients in shock due to both traumatic and nontraumatic causes are often treated with damage control laparotomy and surgical principles. Damage control surgery has also been shown to be safe and effective in thoracic and orthopedic injuries. Damage control resuscitation is used in conjunction with surgical source control to restore patient physiology and prevent further collapse. The overuse of damage control laparotomy, however, is associated with increased morbidity and complications. With advancing technology, catheter- and stent-based endovascular modalities are playing a larger role in the resuscitation and definitive care of patients.SummaryOptimal outcome in the care of the most severely injured patients requires judicious use of damage control surgery supplemented by advancements in resuscitation and surgical adjuncts.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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