Temporary Vascular Continuity during Damage Control

Pm, Reilly; Mf, Rotondo; Jt, Carpenter; Sa, Sherr; Schwab, Christoph

doi:10.1097/00005373-199510000-00028

Cited by 87 publications

(14 citation statements)

References 15 publications

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“…These strategies include pulmonary tractotomy (8-10), stapling of cardiac wounds (11-14), and ligating or temporarily bypassing a main vessel (1, 2, 5-7, 15). Twisting the hilum to control bleeding from central pulmonary lesions has been proposed to gain temporary hemorrhage control and to postpone pneumonectomy (16, 17).…”

Section: Introductionmentioning

confidence: 99%

Damage-control techniques in the management of severe lung trauma

García

Martı́nez

Rodríguez

et al. 2015

Journal of Trauma and Acute Care Surgery

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Background Damage Control (DC) has improved survival from severe abdominal and extremities injuries. The data on the surgical strategies and outcomes in patients managed with DC for severe thoracic injuries is scarce. Methods Retrospective review of the patients treated with DC for thoracic/pulmonary complex trauma at two level I trauma centers from 2006 to 2010. Subjects 14 and older, were included. Demographics, trauma characteristics, surgical techniques, and resuscitation strategies were reviewed. Results A total of 840 trauma thoracotomies were performed. Damage control thoracotomy (DCT) was done in 31 (3.7%). Pulmonary trauma was found in 25 of them. The median age was 28 (IQR 20–34) years, Revised Trauma Score was 7.11, (IQR 5.44–7.55), and Injury Severity Score was 26 (IQR 25–41). Nineteen patients had gunshot-wounds, four stab-wounds and two blunt trauma. Pulmonary trauma was managed by pneumorrhaphy in three cases, tractotomy in 12, wedge resection in one and packing as primary treatment in 8. Clamping of the pulmonary hilum was used as a last resource in 7 cases. Five patients returned to the ICU with the pulmonary hilum occluded by a vascular clamp or an en masse ligature. These patients underwent a deferred resection within 16 to 90 hours after the initial DCT. Four of them survived. Bleeding from other intra-thoracic sources was found in 20 cases: major vessels in nine, heart in three, and thoracic wall in nine. DCT mortality in pulmonary trauma was 6/25, (24%) due to coagulopathy or persistent bleeding in five cases and to multiorgan failure in one. Conclusion This series describes our experience with DCT in severe lung trauma. We describe pulmonary hilum clamping and deferred lung resection as a viable surgical alternative for major pulmonary injuries, and the use of packing as a definitive method for hemorrhage control.

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Section: Introductionmentioning

confidence: 99%

Damage-control techniques in the management of severe lung trauma

García

Martı́nez

Rodríguez

et al. 2015

Journal of Trauma and Acute Care Surgery

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“…[4,25,26] During the last decade, a number of authors have also described use of DCS in cases of thoracic, vascular, orthopedic, and neurosurgical trauma. [27][28][29][30][31] Rotondo and Schwab coined the term "damage control" and outlined logistics of performing 3-phased approach in 1992. [6] They reported survival rate of 77% in patients with major vascular injury and 2 or more visceral injuries.…”

Section: Discussionmentioning

confidence: 99%

Damage Control Surgery – 6 years experiences at a Level 1 Trauma Centre

Gupta¹,

Kumar

Sagar³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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“… 1 7 13 28 29 TIVS are an alternative to ligation, but have rarely been reported in the literature, so outcomes and indications are still to be defined. 30 31 …”

Section: Zonementioning

confidence: 99%

Abdominal vascular trauma

Kobayashi

Costantini

Hamel

et al. 2016

Trauma Surg Acute Care Open

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Abdominal vascular trauma, primarily due to penetrating mechanisms, is uncommon. However, when it does occur, it can be quite lethal, with mortality ranging from 20% to 60%. Increased early mortality has been associated with shock, acidosis, hypothermia, coagulopathy, free intraperitoneal bleeding and advanced American Association for the Surgery of Trauma Organ Injury Scale grade. These patients often arrive at medical centers in extremis and require rapid surgical control of bleeding and aggressive resuscitation including massive transfusion protocols. The most important factor in survival is surgical control of hemorrhage and restoration of appropriate perfusion to the abdominal contents and lower extremities. These surgical approaches and the techniques of definitive vascular repair can be quite challenging, particularly to the inexperienced surgeon. This review hopes to describe the most common abdominal vascular injuries, their presentation, outcomes, and surgical techniques to control and repair such injuries.

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Temporary Vascular Continuity during Damage Control

Cited by 87 publications

References 15 publications

Damage-control techniques in the management of severe lung trauma

Damage-control techniques in the management of severe lung trauma

Damage Control Surgery – 6 years experiences at a Level 1 Trauma Centre

Abdominal vascular trauma

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