Combat damage control surgery

Background:Although the use of damage control surgery for blunt and penetrating injury has been widely reported and defined, the use of damage control surgery on the battlefield (combat damage control surgery) has not been well detailed. Discussion:Damage control surgery is now well established as the standard of care for severely injured civilian patients requiring emergent laparotomy in the United States. The civilian damage control paradigm is based on a “damage control trilogy.” This trilogy comprises an abbreviated operation, intensive care unit resuscitation, and a return to the operating room for the definitive operation. The goal of damage control surgery and the triology is avoidance of irreversible physiological insult termed the lethal triad. The lethal triad comprises the vicious cycle of hypothermia, acidosis, and coagulopathy. Although the damage control model involves the damage control trilogy, abbreviated operation, intensive care unit resuscitation, and definitive operation, all in the same surgical facility, the combat damage control paradigm must incorporate global evacuation through several military surgical facilities and involves up to ten stages to allow for battlefield evacuation, surgical operations, multiple resuscitations, and transcontinental transport. Summary:Combat damage control surgery represents many unique challenges for those who care for the severely injured patients in a combat zone.

[1]  R Rossaint,et al.  Coagulopathy and blood component transfusion in trauma. , 2005, British journal of anaesthesia.

[2]  J. Fortune,et al.  Benefits of intra-abdominal pack placement for the management of nonmechanical hemorrhage. , 1990, Archives of surgery.

[3]  Lorne H Blackbourne,et al.  Selective nonoperative management of penetrating torso injury from combat fragmentation wounds. , 2008, The Journal of trauma.

[4]  D. Nunez,et al.  Can ultrasound replace diagnostic peritoneal lavage in the assessment of blunt trauma? , 1994, Journal of Trauma.

[5]  A. Sauaia,et al.  Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidoses revisited. , 1997, The Journal of trauma.

[6]  O. Alimoğlu,et al.  Intermittent pneumatic compression in the prevention of venous thromboembolism in high-risk trauma and surgical ICU patients. , 2005, Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES.

[7]  P. Giannoudis,et al.  Alterations in the systemic inflammatory response after early total care and damage control procedures for femoral shaft fracture in severely injured patients. , 2005, The Journal of trauma.

[8]  O. Gajic,et al.  Long-haul air travel before major surgery: a prescription for thromboembolism? , 2005, Mayo Clinic proceedings.

[9]  A. Hirshberg,et al.  Prolonged abdominal packing for trauma is associated with increased morbidity and mortality. , 1997, The American surgeon.

[10]  P. Grayburn,et al.  Use of echocardiography to detect occult cardiac injury after penetrating thoracic trauma: a prospective study. , 1995, The Journal of trauma.

[11]  R. E. Wood,et al.  Successful diagnosis of penetrating cardiac injury using surgeon-performed sonography. , 2003, The Annals of thoracic surgery.

[12]  John B Holcomb,et al.  Military trauma training performed in a civilian trauma center. , 2002, The Journal of surgical research.

[13]  A. Tillou,et al.  Thoracic Packing for Uncontrolled Bleeding in Penetrating Thoracic Injuries , 2004, Southern medical journal.

[14]  R. Ivatury,et al.  Intra-abdominal hypertension after life-threatening penetrating abdominal trauma: prophylaxis, incidence, and clinical relevance to gastric mucosal pH and abdominal compartment syndrome. , 1998, The Journal of trauma.

[15]  G. Shaftan,et al.  Ligation: an alternative for control of exsanguination in major vascular injuries. , 1997, The Journal of trauma.

[16]  Penny F Pierce,et al.  Global presence: USAF aeromedical evacuation and critical care air transport. , 2003, Critical care nursing clinics of North America.

[17]  Sandra Bruce,et al.  Preparing to respond: Joint Trauma Training Center and USAF Nursing Warskills Simulation Laboratory. , 2003, Critical care nursing clinics of North America.

[18]  T. Scheck,et al.  Active warming of critically ill trauma patients during intrahospital transfer: A prospective, randomized trial , 2004, Wiener Klinische Wochenschrift.

[19]  E. Moore,et al.  Thomas G. Orr Memorial Lecture. Staged laparotomy for the hypothermia, acidosis, and coagulopathy syndrome. , 1996, American journal of surgery.

[20]  Anthony E. Pusateri,et al.  The Chitosan-Based Hemostatic Dressing: Experience in Current Combat Operations. , 2005, The Journal of trauma.

[21]  I. Persad,et al.  Gunshot injuries to the extremities: experience of a U.K. trauma centre. , 2005, Injury.

[22]  D. McRitchie,et al.  Missed injuries in patients with multiple trauma. , 2000, The Journal of trauma.

[23]  M. Dubick,et al.  Evaluation of commercially available fluid-warming devices for use in forward surgical and combat areas. , 2005, Military medicine.

[24]  M. Sugrue,et al.  Prospective evaluation of early missed injuries and the role of tertiary trauma survey. , 1998, The Journal of trauma.

[25]  P. Giannoudis,et al.  Damage control orthopaedics: evolving concepts in the treatment of patients who have sustained orthopaedic trauma. , 2005, Instructional course lectures.

[26]  L. Chambers,et al.  Initial experience of US Marine Corps forward resuscitative surgical system during Operation Iraqi Freedom. , 2005, Archives of surgery.

[27]  G. Rozycki,et al.  The role of ultrasound in patients with possible penetrating cardiac wounds: a prospective multicenter study. , 1999, The Journal of trauma.

[28]  Charles C. Miller,et al.  Both primary and secondary abdominal compartment syndrome can be predicted early and are harbingers of multiple organ failure. , 2003, The Journal of trauma.

[29]  M. Rotondo,et al.  'Damage control': an approach for improved survival in exsanguinating penetrating abdominal injury. , 1992, The Journal of trauma.

[30]  O. Barnea,et al.  Computer Simulation of Hypothermia during “Damage Control” Laparotomy , 1999, World Journal of Surgery.

[31]  P. Kearney,et al.  Enoxaparin treatment in high-risk trauma patients limits the utility of surveillance venous duplex scanning. , 2001, Journal of vascular surgery.

[32]  T. Grissom,et al.  The provision of sophisticated critical care beyond the hospital: Lessons from physiology and military experiences that apply to civil disaster medical response , 2005, Critical care medicine.

[33]  J Bakker,et al.  Abdominal compartment syndrome , 2004 .

[34]  T. P. Davis,et al.  A prospective study of surgeon-performed ultrasound as the primary adjuvant modality for injured patient assessment. , 1995, The Journal of trauma.

[35]  I. Pipinos,et al.  Limb loss following lower extremity arterial trauma: what can be done proactively? , 2002, Injury.

[36]  D. E. Perkins,et al.  United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield. , 2000, The Journal of trauma.

[37]  G. Kouraklis,et al.  Damage Control Surgery: An Alternative Approach for the Management of Critically Injured Patients , 2002, Surgery Today.

[38]  M. Rotondo,et al.  Temporary vascular continuity during damage control: intraluminal shunting for proximal superior mesenteric artery injury. , 1995, The Journal of trauma.

[39]  S. Stylianos.  Abdominal packing for severe hemorrhage. , 1998, Journal of pediatric surgery.

[40]  E. Moore,et al.  Staged Physiologic Restoration and Damage Control Surgery , 1998, World Journal of Surgery.

[41]  A. Beekley,et al.  The use of damage-control principles for penetrating pelvic battlefield trauma. , 2006, American journal of surgery.

[42]  M. K. Allen,et al.  Causes and patterns of missed injuries in trauma. , 1994, American journal of surgery.

[43]  M. Rotondo,et al.  Damage control surgery for thoracic injuries. , 2004, Injury.

[44]  J. Holcomb,et al.  Independent contributions of hypothermia and acidosis to coagulopathy in swine. , 2005, The Journal of trauma.

[45]  A. Hirshberg,et al.  Hospital trauma care in multiple-casualty incidents: a critical view. , 2001, Annals of emergency medicine.

[46]  J. Rosenfeld.  Damage control neurosurgery. , 2004, Injury.

[47]  D. Sessler,et al.  Effectiveness of resistive heating compared with passive warming in treating hypothermia associated with minor trauma: a randomized trial. , 2001, Mayo Clinic proceedings.

[48]  J. Hess,et al.  Treating coagulopathy in trauma patients. , 2003, Transfusion medicine reviews.

[49]  Matthew J. Wall,et al.  Immediate versus delayed fluid resuscitation for hypotensive patients with penetrating torso injuries. , 1994 .

[50]  A. Hirshberg,et al.  Military, civilian, and rural application of the damage control philosophy. , 2001, Military medicine.

[51]  J. Holcomb.  Fluid resuscitation in modern combat casualty care: lessons learned from Somalia. , 2003, The Journal of trauma.

[52]  D H Jenkins,et al.  Damage control: collective review. , 2000, The Journal of trauma.

[53]  M. Wall,et al.  Damage control for thoracic injuries. , 1997, The Surgical clinics of North America.

[54]  K. Sharp,et al.  Abdominal packing for surgically uncontrollable hemorrhage. , 1992, Annals of surgery.

[55]  F. Vermassen,et al.  Coagulopathy, Hypothermia and Acidosis in Trauma Patients: the Rationale for Damage Control Surgery , 2002, Acta chirurgica Belgica.

[56]  J. Holcomb,et al.  Comparison of 10 different hemostatic dressings in an aortic injury. , 2003, The Journal of trauma.

[57]  P. Gregorić,et al.  [Damage control surgery in abdominal trauma]. , 2010, Acta chirurgica Iugoslavica.

[58]  Kenji Hira,et al.  Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training. , 2002, The Journal of trauma.

[59]  D C Cullinane,et al.  Hypothermia, coagulopathy, and acidosis. , 2000, The Surgical clinics of North America.

[60]  P. Giannoudis,et al.  Damage control: extremities. , 2004, Injury.

[61]  John B Holcomb,et al.  Blood pressure at which rebleeding occurs after resuscitation in swine with aortic injury. , 2003, The Journal of trauma.

[62]  Alec C Beekley,et al.  Combat trauma experience with the United States Army 102nd Forward Surgical Team in Afghanistan. , 2004, American journal of surgery.

[63]  M. Parr,et al.  Damage control surgery and intensive care. , 2004, Injury.

[64]  J. Holcomb,et al.  Forward surgical stabilization of penetrating lower extremity fractures: circular casting versus external fixation. , 2001, Military medicine.

[65]  J R Beck,et al.  Predictive model for survival at the conclusion of a damage control laparotomy. , 2000, American journal of surgery.

[66]  A. Leppäniemi.  Abdominal War Wounds—Experiences from Red Cross Field Hospitals , 2005, World Journal of Surgery.

[67]  R. L. Fulton,et al.  Predicting the need to pack early for severe intra-abdominal hemorrhage. , 1996, The Journal of trauma.

[68]  R. Martin,et al.  Abbreviated laparotomy and planned reoperation for critically injured patients. , 1992, Annals of surgery.

[69]  P M Reilly,et al.  Evolution in damage control for exsanguinating penetrating abdominal injury. , 2001, The Journal of trauma.

[70]  E. Moore,et al.  Feasibility of damage control surgery in the management of military combat casualties. , 2000, Archives of surgery.

[71]  D. E. Fritsch.  Hypothermia in the trauma patient. , 1995, AACN clinical issues.

[72]  S. Alkins,et al.  Long-distance air evacuation of blast-injured sailors from the U.S.S. Cole. , 2002, Aviation Space and Environmental Medicine.

[73]  D. Feliciano,et al.  Opinions of trauma practitioners regarding prehospital interventions for critically injured patients. , 2005, The Journal of trauma.

[74]  R. Bellamy.  The causes of death in conventional land warfare: implications for combat casualty care research. , 1984, Military medicine.

[75]  Richard A. Harris,et al.  Effect of a chitosan-based hemostatic dressing on blood loss and survival in a model of severe venous hemorrhage and hepatic injury in swine. , 2003, The Journal of trauma.

[76]  T. Walters,et al.  Effectiveness of Self-Applied Tourniquets in Human Volunteers , 2005, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[77]  G. Lin,et al.  Tourniquets for hemorrhage control on the battlefield: a 4-year accumulated experience. , 2003, The Journal of trauma.

[78]  K. Boffard,et al.  Damage control in the abdomen and beyond , 2004, The British journal of surgery.

[79]  C. Miller,et al.  Pulmonary tractotomy as an abbreviated thoracotomy technique. , 1998, The Journal of trauma.

[80]  C. Schulman,et al.  A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury. , 2004, The Journal of trauma.

[81]  J. Macarthur,et al.  Hypothermia and acidosis worsen coagulopathy in the patient requiring massive transfusion. , 1991, American journal of surgery.

[82]  S. Neuhaus,et al.  Damage control laparotomy in the Australian military , 2004, ANZ journal of surgery.

[83]  A. Hirshberg,et al.  Planned Reoperation for Severe Trauma , 1995, Annals of surgery.