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Damage Control Surgery: An Update

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Trauma Centers and Acute Care Surgery

Part of the book series: Updates in Surgery ((UPDATESSURG))

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Abstract

Damage control surgery (DCS) represents a staged management approach for those injured patients who present with severe physiological compromise and who require surgical intervention. This strategy focuses on the physiological and biochemical stabilization of the patient prior to the comprehensive anatomical and functional repair of all injuries. DCS can be applied across all body cavities as a continuum, according to the degree of physiological derangement. Appropriate selection of patients requiring DCS is critical. In general, the patient who truly requires DCS is a patient who is more likely to die from an uncorrected shock state than from failure to complete organ repair. Hypothermia, acidosis, coagulopathy in the pre- or intraoperative settings, need for pre- or intraoperative large-volume fluid resuscitation due to the risks of dilutional coagulopathy, visceral edema, intra-abdominal hypertension and abdominal compartment syndrome are the main indications for DCS. Anatomical triggers to DCS are represented by those injuries presenting significant management challenges. The historical three-step DCS has recently been outlined in five clinical phases, which follow one another as a continuum, from recognition of the unwell patient to definitive repair of the injuries. This philosophy is strictly related to the concept of damage control resuscitation.

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Authors and Affiliations

  1. General Surgery and Trauma Team, Niguarda Hospital, Milan, Italy

    Stefania Cimbanassi & Osvaldo Chiara

  2. Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy

    Osvaldo Chiara

Authors
  1. Stefania Cimbanassi
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  2. Osvaldo Chiara
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Correspondence to Stefania Cimbanassi .

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Editors and Affiliations

  1. General Surgery and Trauma Team, Niguarda Hospital, Milan, Italy

    Osvaldo Chiara

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Cimbanassi, S., Chiara, O. (2022). Damage Control Surgery: An Update. In: Chiara, O. (eds) Trauma Centers and Acute Care Surgery. Updates in Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-73155-7_6

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  • DOI: https://doi.org/10.1007/978-3-030-73155-7_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-73154-0

  • Online ISBN: 978-3-030-73155-7

  • eBook Packages: MedicineMedicine (R0)

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