Damage control surgery: It's evolution over the last 20 years
Waibel, Brett H; Rotondo, Michael MF
In less than twenty years, what began as a concept for the treatment of exsanguinating truncal trauma patients has become the primary treatment model for numerous emergent, life threatening surgical conditions incapable of tolerating traditional methods. Its core concepts are relative straightforward and simple in nature: first, proper identification of the patient who is in need of following this paradigm; second, truncation of the initial surgical procedure to the minimal necessary operation; third, aggressive, focused resuscitation in the intensive care unit; fourth, definitive care only once the patient is optimized to tolerate the procedure. These simple underlying principles can be molded to a variety of emergencies, from its original application in combined major vascular and visceral trauma to the septic abdomen and orthopedics. A host of new resuscitation strategies and technologies have been developed over the past two decades, from permissive hypotension and damage control resuscitation to advanced ventilators and hemostatic agents, which have allowed for a more focused resuscitation, allowing some of the morbidity of this model to be reduced. The combination of the simple, malleable paradigm along with better understanding of resuscitation has proven to be a potent blend. As such, what was once an almost lethal injury (combined vascular and visceral injury) has become a survivable one.
Waibel, Brett H, & Rotondo, Michael MF. (March 2012). Damage control surgery: It's evolution over the last 20 years. Revista do Colégio Brasileiro de Cirurgiões, (39:4), p.314-321. Retrieved from http://hdl.handle.net/10342/7857
Waibel, Brett H, and Rotondo, Michael MF. "Damage control surgery: It's evolution over the last 20 years". Revista do Colégio Brasileiro de Cirurgiões. 39:4. (314-321.), March 2012. October 24, 2020. http://hdl.handle.net/10342/7857.
Waibel, Brett H and Rotondo, Michael MF, "Damage control surgery: It's evolution over the last 20 years," Revista do Colégio Brasileiro de Cirurgiões 39, no. 4 (March 2012), http://hdl.handle.net/10342/7857 (accessed October 24, 2020).
Waibel, Brett H, Rotondo, Michael MF. Damage control surgery: It's evolution over the last 20 years. Revista do Colégio Brasileiro de Cirurgiões. March 2012; 39(4) 314-321. http://hdl.handle.net/10342/7857. Accessed October 24, 2020.