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Adaptation of Military Damage Control in Civilian Settings

  • Kelly A. Fair
  • Martin A. Schreiber
Chapter

Abstract

Damage control techniques originated during battlefield experience millennia ago. In the early twentieth century, damage control was utilized to limit hemorrhage from liver injuries. Since then damage control has evolved to include damage control surgery and damage control resuscitation in the military setting, which has been translated and integrated into civilian trauma and emergency general surgery practice. Application of damage control techniques in the military and civilian settings has been studied extensively. Damage control resuscitation in particular has made rapid and marked progress in the past 20 years. Hemostatic resuscitation became common practice in the military during modern Iraq and Afghanistan conflict. This led to application and study in the civilian setting. Differences between military and civilian settings include austere military environments, limited resources, and complex evacuation requirements. Future application of damage control in the civilian setting requires integration and collaboration between the military and civilian sectors.

Keywords

Damage control resuscitation Damage control surgery Military Civilian 

Abbreviations

DC

Damage control

DCR

Damage control resuscitation

DCS

Damage control surgery

OEF/OIF

Operation Iraqi Freedom/Operation Enduring Freedom

PROMMTT

Prospective, Observational, Multicenter, Major Trauma Transfusion

PROPPR

Pragmatic Randomized Optimal Platelet and Plasma Ratios

Notes

Acknowledgments

The authors would like to thank the staff of the Trauma Research Laboratory at Oregon Health & Science University.

References

  1. 1.
    Defense Do. U.S. Navy Surface ship survivability. Washington, D.C.; 1996. P. 3–20.Google Scholar
  2. 2.
    Rotondo MF, Schwab CW, McGonigal MD, Phillips GR, Fruchterman TM, Kauder DR, et al. 'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury. J Trauma. 1993;35(3):375–82. discussion 82-3CrossRefPubMedGoogle Scholar
  3. 3.
    Rosenfeld JV. Damage control neurosurgery. Injury. 2004;35(7):655–60.CrossRefPubMedGoogle Scholar
  4. 4.
    Wall MJ, Villavicencio RT, Miller CC, Aucar JA, Granchi TA, Liscum KR, et al. Pulmonary tractotomy as an abbreviated thoracotomy technique. J Trauma. 1998;45(6):1015–23.CrossRefPubMedGoogle Scholar
  5. 5.
    Hildebrand F, Giannoudis P, Kretteck C, Pape HC. Damage control: extremities. Injury. 2004;35(7):678–89.CrossRefPubMedGoogle Scholar
  6. 6.
    Schreiber MA. The beginning of the end for damage control surgery. Br J Surg. 2012;99(Suppl 1):10–1.CrossRefPubMedGoogle Scholar
  7. 7.
    Moore EE. Thomas G. Orr Memorial Lecture. Staged laparotomy for the hypothermia, acidosis, and coagulopathy syndrome. Am J Surg. 1996;172(5):405–10.CrossRefPubMedGoogle Scholar
  8. 8.
    Cosgriff N, Moore EE, Sauaia A, Kenny-Moynihan M, Burch JM, Galloway B. Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidoses revisited. J Trauma. 1997;42(5):857–61. discussion 61-2CrossRefPubMedGoogle Scholar
  9. 9.
    Kashuk JL, Moore EE, Millikan JS, Moore JB. Major abdominal vascular trauma--a unified approach. J Trauma. 1982;22(8):672–9.CrossRefPubMedGoogle Scholar
  10. 10.
    Galante JM, Smith CA, Sena MJ, Scherer LA, Tharratt RS. Identification of barriers to adaptation of battlefield technologies into civilian trauma in California. Mil Med. 2013;178(11):1227–30.CrossRefPubMedGoogle Scholar
  11. 11.
    Haider AH, Piper LC, Zogg CK, Schneider EB, Orman JA, Butler FK, et al. Military-to-civilian translation of battlefield innovations in operative trauma care. Surgery. 2015;158(6):1686–95.CrossRefPubMedGoogle Scholar
  12. 12.
    Bickell WH, Wall MJ, Pepe PE, Martin RR, Ginger VF, Allen MK, et al. Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. N Engl J Med. 1994;331(17):1105–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Balogh Z, McKinley BA, Cocanour CS, Kozar RA, Valdivia A, Sailors RM, et al. Supranormal trauma resuscitation causes more cases of abdominal compartment syndrome. Arch Surg. 2003;138(6):637–42. discussion 42-3CrossRefPubMedGoogle Scholar
  14. 14.
    Borgman MA, Spinella PC, Perkins JG, Grathwohl KW, Repine T, Beekley AC, et al. The ratio of blood products transfused affects mortality in patients receiving massive transfusions at a combat support hospital. J Trauma. 2007;63(4):805–13.CrossRefPubMedGoogle Scholar
  15. 15.
    Holcomb JB, Wade CE, Michalek JE, Chisholm GB, Zarzabal LA, Schreiber MA, et al. Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008;248(3):447–58.PubMedGoogle Scholar
  16. 16.
    Spinella PC, Perkins JG, Grathwohl KW, Beekley AC, Niles SE, McLaughlin DF, et al. Effect of plasma and red blood cell transfusions on survival in patients with combat related traumatic injuries. J Trauma. 2008;64(2 Suppl):S69–77. discussion S-8CrossRefPubMedGoogle Scholar
  17. 17.
    Stansbury LG, Branstetter JG, Lalliss SJ. Amputation in military trauma surgery. J Trauma. 2007;63(4):940–4.CrossRefPubMedGoogle Scholar
  18. 18.
    Kinch KJ, Clasper JC. A brief history of war amputation. J R Army Med Corps. 2011;157(4):374–80.CrossRefPubMedGoogle Scholar
  19. 19.
    Pringle JHV. Notes on the arrest of hepatic hemorrhage due to trauma. Ann Surg. 1908;48(4):541–9.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Stone HH, Strom PR, Mullins RJ. Management of the major coagulopathy with onset during laparotomy. Ann Surg. 1983;197(5):532–5.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Waibel BH, Rotondo MM. Damage control surgery: it's evolution over the last 20 years. Rev Col Bras Cir. 2012;39(4):314–21.CrossRefPubMedGoogle Scholar
  22. 22.
    Roberts DJ, Ball CG, Feliciano DV, Moore EE, Ivatury RR, Lucas CE, et al. History of the innovation of damage control for management of trauma patients: 1902-2016. Ann Surg. 2017;265(5):1034–44.CrossRefPubMedGoogle Scholar
  23. 23.
    Glassberg E, Nadler R, Erlich T, Klien Y, Kreiss Y, Kluger Y. A decade of advances in military trauma care. Scand J Surg. 2014;103(2):126–31.CrossRefPubMedGoogle Scholar
  24. 24.
    Thorson CM, Dubose JJ, Rhee P, Knuth TE, Dorlac WC, Bailey JA, et al. Military trauma training at civilian centers: a decade of advancements. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S483–9.CrossRefPubMedGoogle Scholar
  25. 25.
    Hooper TJ, Nadler R, Badloe J, Butler FK, Glassberg E. Implementation and execution of military forward resuscitation programs. Shock. 2014;41(Suppl 1):90–7.CrossRefPubMedGoogle Scholar
  26. 26.
    Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, et al. Death on the battlefield (2001-2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–7.CrossRefPubMedGoogle Scholar
  27. 27.
    Holcomb JB, McMullin NR, Pearse L, Caruso J, Wade CE, Oetjen-Gerdes L, et al. Causes of death in U.S. Special Operations Forces in the global war on terrorism: 2001-2004. Ann Surg. 2007;245(6):986–91.CrossRefPubMedPubMedCentralGoogle Scholar
  28. 28.
    Gawande A. Casualties of war--military care for the wounded from Iraq and Afghanistan. N Engl J Med. 2004;351(24):2471–5.CrossRefPubMedGoogle Scholar
  29. 29.
    Langan NR, Eckert M, Martin MJ. Changing patterns of in-hospital deaths following implementation of damage control resuscitation practices in US forward military treatment facilities. JAMA Surg. 2014;149(9):904–12.CrossRefPubMedGoogle Scholar
  30. 30.
    Champion HR, Bellamy RF, Roberts CP, Leppaniemi AA. Profile of combat injury. J Trauma. 2003;54(5 Suppl):S13–9.PubMedPubMedCentralGoogle Scholar
  31. 31.
    Schreiber MA, Zink K, Underwood S, Sullenberger L, Kelly M, Holcomb JB. A comparison between patients treated at a combat support hospital in Iraq and a level I trauma center in the United States. J Trauma. 2008;64(2 Suppl):S118–21. discussion S21-2CrossRefPubMedGoogle Scholar
  32. 32.
    Sambasivan CN, Underwood SJ, Cho SD, Kiraly LN, Hamilton GJ, Kofoed JT, et al. Comparison of abdominal damage control surgery in combat versus civilian trauma. J Trauma. 2010;69(Suppl 1):S168–74.CrossRefPubMedGoogle Scholar
  33. 33.
    Blackbourne LH. Combat damage control surgery. Crit Care Med. 2008;36(7 Suppl):S304–10.CrossRefPubMedGoogle Scholar
  34. 34.
    Blackbourne LH, McMullin N, Eastridge B, Baskin T, Holcomb J. Aggressive proactive combat damage control surgery. US Army Med Dep J. 2007:3–6.Google Scholar
  35. 35.
    Pfeffermann R, Rozin RR, Durst AL, Marin G. Modern war surgery: operations in an evacuation hospital during the October 1973 Arab-Israeli war. J Trauma. 1976;16(9):694–703.CrossRefPubMedGoogle Scholar
  36. 36.
    Silliman CC, Moore EE, Johnson JL, Gonzalez RJ, Biffl WL. Transfusion of the injured patient: proceed with caution. Shock. 2004;21(4):291–9.CrossRefPubMedGoogle Scholar
  37. 37.
    Campion EM, Pritts TA, Dorlac WC, Nguyen AQ, Fraley SM, Hanseman D, et al. Implementation of a military-derived damage-control resuscitation strategy in a civilian trauma center decreases acute hypoxia in massively transfused patients. J Trauma Acute Care Surg. 2013;75(2 Suppl 2):S221–7.CrossRefPubMedPubMedCentralGoogle Scholar
  38. 38.
    Holcomb JB, Fox EE, Wade CE, Group PS. The prospective observational multicenter major trauma transfusion (PROMMTT) study. J Trauma Acute Care Surg. 2013;75(1 Suppl 1):S1–2.CrossRefPubMedGoogle Scholar
  39. 39.
    Holcomb JB, del Junco DJ, Fox EE, Wade CE, Cohen MJ, Schreiber MA, et al. The prospective, observational, multicenter, major trauma transfusion (PROMMTT) study: comparative effectiveness of a time-varying treatment with competing risks. JAMA Surg. 2013;148(2):127–36.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 40.
    Holcomb JB, Tilley BC, Baraniuk S, Fox EE, Wade CE, Podbielski JM, et al. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015;313(5):471–82.CrossRefPubMedPubMedCentralGoogle Scholar
  41. 41.
    Roberts DJ, Bobrovitz N, Zygun DA, Ball CG, Kirkpatrick AW, Faris PD, et al. Indications for use of thoracic, abdominal, pelvic, and vascular damage control interventions in trauma patients: a content analysis and expert appropriateness rating study. J Trauma Acute Care Surg. 2015;79(4):568–79.CrossRefPubMedGoogle Scholar
  42. 42.
    Roberts DJ, Bobrovitz N, Zygun DA, Ball CG, Kirkpatrick AW, Faris PD, et al. Indications for use of damage control surgery in civilian trauma patients: a content analysis and expert appropriateness rating study. Ann Surg. 2016;263(5):1018–27.CrossRefPubMedGoogle Scholar
  43. 43.
    Cotton BA, Reddy N, Hatch QM, LeFebvre E, Wade CE, Kozar RA, et al. Damage control resuscitation is associated with a reduction in resuscitation volumes and improvement in survival in 390 damage control laparotomy patients. Ann Surg. 2011;254(4):598–605.CrossRefPubMedGoogle Scholar
  44. 44.
    Yonge JD, Schreiber MA. The pragmatic randomized optimal platelet and plasma ratios trial: what does it mean for remote damage control resuscitation? Transfusion. 2016;56(Suppl 2):S149–56.CrossRefPubMedGoogle Scholar
  45. 45.
    Jenkins D, Stubbs J, Williams S, Berns K, Zielinski M, Strandenes G, et al. Implementation and execution of civilian remote damage control resuscitation programs. Shock. 2014;41(Suppl 1):84–9.CrossRefPubMedGoogle Scholar
  46. 46.
    Austin MT, Diaz JJ, Feurer ID, Miller RS, May AK, Guillamondegui OD, et al. Creating an emergency general surgery service enhances the productivity of trauma surgeons, general surgeons and the hospital. J Trauma. 2005;58(5):906–10.CrossRefPubMedGoogle Scholar
  47. 47.
    Stawicki SP, Brooks A, Bilski T, Scaff D, Gupta R, Schwab CW, et al. The concept of damage control: extending the paradigm to emergency general surgery. Injury. 2008;39(1):93–101.CrossRefPubMedGoogle Scholar
  48. 48.
    Waibel BH, Rotondo MF. Damage control for intra-abdominal sepsis. Surg Clin North Am. 2012;92(2):243–57. viiiCrossRefPubMedGoogle Scholar
  49. 49.
    Cancio LC, Rasmussen TE, Cannon JW, Dubick MA. The vital civilian-military link in combat casualty care research: impact of attendance at scientific conferences. J Trauma Acute Care Surg. 2015;79(4 Suppl 2):S221–6.CrossRefPubMedGoogle Scholar
  50. 50.
    Dubose J, Rodriguez C, Martin M, Nunez T, Dorlac W, King D, et al. Preparing the surgeon for war: present practices of US, UK, and Canadian militaries and future directions for the US military. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S423–30.CrossRefPubMedGoogle Scholar
  51. 51.
    Hight RA, Salcedo ES, Martin SP, Cocanour CS, Utter G, Galante JM. Level I academic trauma center integration as a model for sustaining combat surgical skills: the right surgeon in the right place for the right time. J Trauma Acute Care Surg. 2015;78(6):1176–81.CrossRefPubMedGoogle Scholar
  52. 52.
    Knuth TE. The peacetime trauma experience of U.S. Army surgeons: another call for collaborative training in civilian trauma centers. Mil Med. 1996;161(3):137–42.CrossRefPubMedGoogle Scholar
  53. 53.
    Schreiber MA, Holcomb JB, Conaway CW, Campbell KD, Wall M, Mattox KL. Military trauma training performed in a civilian trauma center. J Surg Res. 2002;104(1):8–14.CrossRefPubMedGoogle Scholar
  54. 54.
    Academies N. A national trauma care system: integrating military and civilian trauma systems to achieve zero preventable deaths after injury. 2016. http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2016/Trauma-Care/Trauma-Care-Recs.pdf.

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Trauma, Critical Care, and Acute Care SurgeryOregon Health and Science UniversityPortlandUSA
  2. 2.Division of Trauma, Critical Care and Acute Care Surgery, School of MedicineOregon Health and Science UniversityPortlandUSA

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