J Korean Med Assoc.  2024 Dec;67(12):732-736. 10.5124/jkma.2024.67.12.732.

The meaning and principles of damage control surgery

• Lee GJ

• KMID: 2563308
• DOI: http://doi.org/10.5124/jkma.2024.67.12.732

Abstract

Background
Trauma, especially hemorrhagic injury, remains a leading cause of morbidity and mortality worldwide. Prompt and effective management of these injuries is essential to improve patient outcomes.
Current Concepts
Damage control surgery (DCS) has become a crucial approach for managing patients with severe traumatic hemorrhagic shock. DCS prioritizes physiological stabilization rather than definitive anatomical repair, initially focusing on controlling the hemorrhage and preventing further complications. This strategy is pertinent in patients with polytrauma, in which immediate surgical interventions can help mitigate the lethal triad of hypothermia, acidosis, and coagulopathy.
Discussion and Conclusion
The implementation of DCS involves rapid identification of bleeding sources, followed by temporary measures, such as packing and revascularization. Advanced techniques, including resuscitative endovascular balloon occlusion of the aorta and preperitoneal pelvic packing, have further enhanced hemorrhagic control in complex pelvic fractures and intra-abdominal injuries. These methods enable surgeons to promptly stabilize critically injured patients while preserving the options for definitive surgery after initial resuscitation. DCS represents a paradigm shift in the management of traumatic hemorrhage, emphasizing the need for timely intervention and effective resource allocation in trauma care. By understanding and applying the principles of DCS, healthcare providers can improve the survival rates of patients with trauma and lifethreatening hemorrhages.

Keyword

Emergency medical services; Health personnel; Morbidity; Multiple trauma; Resource allocation; 응급의료서비스; 의료진; 이환율; 다중외상; 자원할당