Damage control surgery is defined as rapid termination of an operation after control
of life-threatening bleeding and contamination followed by correction of physiologic
abnormalities and definitive management. This modern strategy involves a staged approach
to multiply injured patients designed to avoid or correct the lethal triad of hypothermia,
acidosis, and coagulopathy before definitive management of injuries. It is applicable
to a wide variety of disciplines. During the first stage of damage control, hemorrhage
is stopped, and contamination is controlled using the simplest and most rapid means
available. Temporary wound closure methods are employed. The second stage is characterized
by correction of physiologic abnormalities in the ICU. Patients are warmed and resuscitated,
and coagulation defects are corrected. In the final phase of damage control, definitive
operative management is completed in a stable patient.
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