Damage Control Principles Applied to Penetrating Neck and Mandibular Injury

Rezende-Neto, João; Marques, Aluisio Cardoso; Guedes, Lucas José; Teixeira, Luiz Carlos

doi:10.1097/ta.0b013e318166d2d2

Cited by 21 publications

(11 citation statements)

References 6 publications

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“…Damage control strategies have been applied initially to abdominal trauma [ 9 ] and subsequently to other fields such as thoracic surgery [ 10 ] and orthopedics [ 11 ]; relatively high survival rates with these strategies have been reported [ 5 – 7 , 12 ]. Case reports demonstrate the benefits of applying damage control principles to maxillofacial and neck trauma patients [ 13 , 14 ]. Appropriate selection of patients that can benefit from DCS is very important.…”

Section: Reviewmentioning

confidence: 99%

Maxillofacial and neck trauma: a damage control approach

Krausz

Picetti

2015

World J Emerg Surg

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Severe maxillofacial and neck trauma exposes patients to life threatening complications such as airway compromise and hemorrhagic shock. These conditions require rapid actions (diagnosis and management) and a strong interplay between surgeons and anesthesiologists. Effective airway management often makes the difference between life and death in severe maxillofacial and neck trauma and takes initial precedence over all other clinical considerations. Damage control strategies focus on physiological and biochemical stabilization prior to the comprehensive anatomical and functional repair of all injuries. Damage control surgery (DCS) can be defined as the rapid initial control of hemorrhage and contamination, temporary wound closure, resuscitation to normal physiology in the intensive care unit (ICU) and subsequent reexploration and definitive repair following restoration of normal physiology. Damage control resuscitation (DCR) consists mainly of hypotensive (permissive hypotension) and hemostatic (minimal use of crystalloid fluids and utilization of blood and blood products) resuscitation. Both strategies should be administered simultaneously in all of these patients.

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Section: Reviewmentioning

confidence: 99%

Maxillofacial and neck trauma: a damage control approach

Krausz

Picetti

2015

World J Emerg Surg

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“…The placement of Foley catheters in the submandibular and floor of mouth regions for emergent control of hard to control, severe haemorrhage in penetrating ballistic maxillofacial wounds has been recently described, and is a useful maxillofacial 'damage control' technique [20]. Examples of commercial nasal packs are the Merocel Doyle's nasal dressing for anterior nasal haemorrhage control and the Epistat II nasal catheter for both anterior and posterior nasal haemorrhage control (Figure 3).…”

Section: Facial Haemorrhage Managementmentioning

confidence: 99%

Training Australian military health care personnel in the primary care of maxillofacial wounds from improvised explosive devices

2010

J R Army Med Corps

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Severe facial wounds frequently result from improvised explosive devices (IEDs) as the face is still vulnerable despite advances in personal protection of soldiers. In contrast to the poor outcomes with civilian maxillofacial trauma management methods initially employed by the US Army for maxillofacial wounds from IEDs, advances in wound management methods for such injuries by the US Army have resulted in significant improvements in appearance and function. This article describes the features of a short course in the primary management of combat related maxillofacial wounds for deployed health care personnel who may not be facial specialists, including contemporary treatment techniques for those confronting wounds from IEDs which are explained in this course.

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“…In open fractures caused by blunt trauma and in extremity injuries resulting from penetrating trauma or blast; external blood loss is limited by the use of extremity tourniquets, with excellent results in the military [ 11 , 12 ] and civilian [ 13 – 16 ] setting. Extreme nasopharyngeal and/or oropharyngeal bleeding can be countered by gauze packing and/or improvised Bellocq -tamponade with Foley-catheters [ 17 , 18 ]. Hemostatic suturing, direct digital pressure and the use of pressure bandages will prevent ongoing blood loss from external wounds such as scalp lacerations [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

Prehospital control of life-threatening truncal and junctional haemorrhage is the ultimate challenge in optimizing trauma care; a review of treatment options and their applicability in the civilian trauma setting

Oostendorp

Tan²,

Geeraedts

2016

Scand J Trauma Resusc Emerg Med

104

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IntroductionExsanguination following trauma is potentially preventable. Extremity tourniquets have been successfully implemented in military and civilian prehospital care. Prehospital control of bleeding from the torso and junctional area’s remains challenging but offers a great potential to improve survival rates. This review aims to provide an overview of potential treatment options in both clinical as preclinical state of research on truncal and junctional bleeding. Since many options have been developed for application in the military primarily, translation to the civilian situation is discussed.MethodsMedline (via Pubmed) and Embase were searched to identify known and potential prehospital treatment options. Search terms were|: haemorrhage/hemorrhage, exsanguination, junctional, truncal, intra-abdominal, intrathoracic, intervention, haemostasis/hemostasis, prehospital, en route, junctional tourniquet, REBOA, resuscitative thoracotomy, emergency thoracotomy, pelvic binder, pelvic sheet, circumferential. Treatment options were listed per anatomical site: axilla, groin, thorax, abdomen and pelvis Also, the available evidence was graded in (pre) clinical stadia of research.ResultsIdentified treatment options were wound clamps, injectable haemostatic sponges, pelvic circumferential stabilizers, resuscitative thoracotomy, resuscitative endovascular balloon occlusion of the aorta (REBOA), intra-abdominal gas insufflation, intra-abdominal self-expanding foam, junctional and truncal tourniquets. A total of 70 papers on these aforementioned options was retrieved. No clinical reports on injectable haemostatic sponges, intra-abdominal insufflation or self-expanding foam injections and one type of junctional tourniquets were available.ConclusionOptions to stop truncal and junctional traumatic haemorrhage in the prehospital arena are evolving and may offer a potentially great survival advantage. Because of differences in injury pattern, time to definitive care, different prehospital scenario’s and level of proficiency of care providers; successful translation of various military applications to the civilian situation has to be awaited. Overall, the level of evidence on the retrieved adjuncts is extremely low.

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Damage Control Principles Applied to Penetrating Neck and Mandibular Injury

Cited by 21 publications

References 6 publications

Maxillofacial and neck trauma: a damage control approach

Maxillofacial and neck trauma: a damage control approach

Training Australian military health care personnel in the primary care of maxillofacial wounds from improvised explosive devices

Prehospital control of life-threatening truncal and junctional haemorrhage is the ultimate challenge in optimizing trauma care; a review of treatment options and their applicability in the civilian trauma setting

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