Damage Control: Collective Review

Shapiro, Michael B.; Jenkins, Donald H.; Schwab, C. William; Rotondo, and Michael F.

doi:10.1097/00005373-200011000-00033

Cited by 440 publications

(285 citation statements)

References 91 publications

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“…Despite the use of damage control in trauma patients, the mortality-associated damage control has been reported above 40% in some series [114][115][116][117][118][119][120].…”

Section: Viability Of the Bowelmentioning

confidence: 99%

Management of Peritonitis in the Critically Ill Patient

Ordóñez

Puyana

2006

Surgical Clinics of North America

108

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“…Despite the use of damage control in trauma patients, the mortality-associated damage control has been reported above 40% in some series [114][115][116][117][118][119][120].…”

Section: Viability Of the Bowelmentioning

confidence: 99%

Management of Peritonitis in the Critically Ill Patient

Ordóñez

Puyana

2006

Surgical Clinics of North America

108

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“…[97][98][99] To classify patients in a critical condition, general surgeons use the term ''triad of death,'' 81 consisting of the degree of shock, hypothermia, and coagulopathy. 109 Although these factors have been largely tested in patients with penetrating injuries, 110 we confirmed that they are also relevant for patients with blunt trauma and appear to be feasible for use in the decision-making process in the emergency room. 42,111 Additionally, we determined that the polytrauma patient with blunt injuries has additional problems in terms of soft tissue injuries which are underrepresented if the ''triad of death'' is used alone classify the patient.…”

Section: Resultsmentioning

confidence: 54%

Effects of changing strategies of fracture fixation on immunologic changes and systemic complications after multiple trauma: Damage control orthopedic surgery

Pape

2008

Journal Orthopaedic Research

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In the treatment of polytrauma patients, multiple studies have shown how the timing and the type of the initial surgery of long bone fractures influence the incidence of systemic complications. Database analyses documented that unduly long surgical procedures undertaken early after trauma increase the risk of acute respiratory distress syndrom (ARDS), especially when femoral shaft fractures are stabilized. Animal research and prospective clinical studies also support the fact that the type of stabilization of a femoral shaft fracture may influence the systemic response to trauma. Reamed intramedullary reaming and nailing for a femoral shaft fracture is associated with an increased risk of pulmonary fat embolization from the medullary canal. This can result in pulmonary compromise if certain cofactors are also present. Modified reamers have been developed to reduce this side effect. The mediating effects are immunologic changes, varying according to the magnitude of the surgical procedure. Pro-inflammatory markers (e.g., Interleukins) may be used to assess the inflammatory response to injury as well as the magnitude of surgery and the systemic impact induced by surgery. Serum levels of such markers can be used clinically to tailor the amount of surgery that is performed to the clinical condition of the patient. The potentially negative impact of excessive surgery in high-risk patients can be avoided by using a new grading system for the assessment of the clinical status of the injured patient. Most recently, a large prospective randomized multicenter study has documented that this grading system is effective for identifying these borderline patients, and that in the borderline patient a staged surgical approach, such as temporary femoral stabilization with an external fixator, reduces the incidence of systemic complications. This work has changed the surgical management of multiply injured patients toward an approach that is tailored to the clinical condition of the patient, as indicated by well-defined clinical parameters as well as objective measurements of serum cytokine levels. ß

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“…14 Coagulopathy develops in 44% of all seriously injured 15 patients and accounts for most deaths that occur in the first 24 h of admission after trauma. 16 The mechanism of coagulopathy is multifactorial. Postinjury, the predominant factor is core hypothermia.…”

Section: Coagulopathymentioning

confidence: 99%