Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Jan;31(1):30-35.
doi: 10.1055/s-0037-1602177. Epub 2017 Dec 19.

The Evolution of Damage Control in Concept and Practice

Brian C Beldowicz  1
Affiliations
Review

The Evolution of Damage Control in Concept and Practice

Brian C Beldowicz. Clin Colon Rectal Surg. 2018 Jan.

Abstract

Damage 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.

Keywords: damage control; damage control resuscitation; damage control surgery; lethal triad.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest This article represents the opinions of the author alone and does not represent official views of the Department of Defense, the Department of the Army, or any of his affiliated institutions.

References

    1. Cirocchi R, Montedori A, Farinella E, Bonacini I, Tagliabue L, Abraha I. Damage control surgery for abdominal trauma. Cochrane Database Syst Rev. 2013;3(03):CD007438. - PMC - PubMed
    1. Pringle J H. V. Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg. 1908;48(04):541–549. - PMC - PubMed
    1. Aprahamian C, Wittmann D H, Bergstein J M, Quebbeman E J. Temporary abdominal closure (TAC) for planned relaparotomy (etappenlavage) in trauma. J Trauma. 1990;30(06):719–723. - PubMed
    1. Feliciano D V, Mattox K L, Burch J M, Bitondo C G, Jordan G L., Jr Packing for control of hepatic hemorrhage. J Trauma. 1986;26(08):738–743. - PubMed
    1. Cué J I, Cryer H G, Miller F B, Richardson J D, Polk H C., JrPacking and planned reexploration for hepatic and retroperitoneal hemorrhage: critical refinements of a useful technique J Trauma 199030081007–1011., discussion 1011–1013 - PubMed