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Damage Control Management in the Polytrauma Patient pp 111–116Cite as

General Surgery Approach to DC: Decision Making and Indications

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Abstract

“Damage control surgery” is a management approach to the injured or critically ill patient who is approaching physiologic exhaustion that aims to minimize or further worsen the lethal triad of acidosis, hypothermia, and coagulopathy. The patient’s overall management is divided into phases through which the surgeon must maneuver. At the minimum, these phases consist of the index operation, a period of resuscitation, and are followed by definitive repair. Patient selection for damage control surgery should be based on certain indicators such as patient-specific factors, mechanism/injury patterns, and degree of physiologic derangements. The initial goal of damage control surgery is the control of hemorrhage and to stop gastrointestinal contamination. There are subtitle key findings which can provide clues for the surgeon when to stop the operation and proceed to the ICU for further resuscitation. Various intraoperative techniques and approaches for the index operation are summarized and discussed.

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Author information

Authors and Affiliations

  1. R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, Baltimore, MD, USA

    Molly Deane MD & Jose J. Diaz Jr MD, CNS, FACS, FCCM

Authors
  1. Molly Deane MD
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  2. Jose J. Diaz Jr MD, CNS, FACS, FCCM
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Corresponding author

Correspondence to Jose J. Diaz Jr MD, CNS, FACS, FCCM .

Editor information

Editors and Affiliations

  1. Department of Trauma, Zurich University, Zurich, Switzerland

    Hans-Christoph Pape

  2. Division of General Surgery, University of Pittsburgh, School of Medicine, Pittsburgh, Pennsylvania, USA

    Andrew B. Peitzman

  3. Department of Surgery, Division of Acute Care Surgery, University of Rochester, Medical Center, Rochester, New York, USA

    Michael F. Rotondo

  4. Department of Academic Trauma & Orthopaedics, University of Leeds, Leeds, West Yorkshire, United Kingdom

    Peter V. Giannoudis

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© 2017 Springer International Publishing AG

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Deane, M., Diaz, J.J. (2017). General Surgery Approach to DC: Decision Making and Indications. In: Pape, HC., Peitzman, A., Rotondo, M., Giannoudis, P. (eds) Damage Control Management in the Polytrauma Patient. Springer, Cham. https://doi.org/10.1007/978-3-319-52429-0_11

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  • DOI: https://doi.org/10.1007/978-3-319-52429-0_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-52427-6

  • Online ISBN: 978-3-319-52429-0

  • eBook Packages: MedicineMedicine (R0)

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