USA.gov. Damage Control Surgery. 2008 Jan;39(1):93-101. doi: 10.1016/j.injury.2007.06.011. Damage Control (DC) strategies have gained wide acceptance in the management of abdominal trauma patients physiologically exhausted by coagulopathy, hypothermia, and acidosis. Specific DC maneuvers have been created to speed up critical thoracic trauma surgery. The aim of this strategy is to facilitate surgical control of haemorrhage and contamination, the stabilisation of potentially fatal problems at first look laparotomy, with secondary resuscitation followed by scheduled definitive surgery. �B��+� Part 2 occurs in the ICU. Military conflict has always driven innovation and technical advances in medicine and surgery. A�Bҩ���8��p��f�W��9�I�Hج�,���{�ۉE;!4 -�� 0 ��p� �F'B��3��J����N��Q�,��{D�y}p�-'�yPٸx8)�ۻFx��/e��o�ώg��R@{��7����վCrZJ[I�׼x\�W��O�bV���^��f%�u����Gq_f�g�o'�����h1���yS���.�����.ۺ���i����vV Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Zizzo M, Castro Ruiz C, Zanelli M, Bassi MC, Sanguedolce F, Ascani S, Annessi V. Medicine (Baltimore). ���`)Y endstream endobj 151 0 obj <>stream 4. H��T�n�0��+x$��%Y�� @�����B@$9ЯX���b�ߝ%��ۦ����rwH��2��"� ��: a�{R�����n,z�����ߍo�������59��,������dEa��0L�_� F���i ��F���C���{> Leaving an abdominal cavity temporarily open has been well described for several indications, including damage control surgery and abdominal compartment syndrome. 1998 Sep;85(9):1217-20 1 damage control resuscitation (DCR) emerged as an extension of a principle used by trauma surgeons called damage control surgery (DCS), which limits surgical interventions to those which address life-threatening injuries and delays all other surgical care until metabolic and physiologic derangements have been treated. 2014 Jan;101(1):e109-18. 2020 Nov 25;99(48):e23323. Coagulopathy is common in patients with haemorrhagic shock. %PDF-1.5 %���� Damage Control Resuscitation (DCR) is generally accepted as a complementar y strategy usually paired with Damage Control Surgery (DCS), which focuses surgical interventions to those which address lif e-threatening injuries and delays all other surgical care until … The major principles of DCR are to restore homeostasis, prevent or mitigate the … Damage control is well recognized as a surgical strategy that sacrifices the completeness of the immediate repair in order adequately to address the combined physiological impact of trauma and surgery. in the initial stage of damage control, hemorrhage is stopped, contamination is controlled, and temporary wound closure methods may be employed. 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The decision to perform DCS was triggered by the presence of at least one trauma DCS criterion: hypotension (<70 mmHg), hypothermia (<35 °C), acidosis (pH < 7.25), coagulopathy (INR ≥ 1.7) and massive (>5 RBC) transfusion. �B��+� Damage control surgery is utilized for critically ill or injured patients as an early initial step to definitive surgical management. Observed outcomes were compared to those predicted by commonly employed scores (APACHE II, POSSUM, P-POSSUM, SAPS II). DCR aims to restore homeostasis and prevent or mitigate tissue hypoxia and coagulopathy. In orthopedic surgery, the focus of damage control surgery is often to control hemorrhage, Der Ursprung der DCS liegt im Stoppen der Blutung und Kontrolle der Kontamination des schwer verletzten Abdomens. What is damage control resuscitation (DCR)? Patients with peritonitis and acute pancreatitis are those who benefit most of the DCS approach. Conclusions: Br J Surg. 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