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ABSTRACT… Objectives: To study the impact of "High Dependency Unit" care on outcome of surgical patients. Study Design: Descriptive, Prospective. Setting: Surgical Department of Aziz Bhatti Shaheed (Teaching) Hospital. Nawaz Sharif medical College, University of the Gujrat. Study Period: January 1 st to December 31th 2016. Results: A total of 275 patients of all age groups from surgical and allied specialities requiring dedicated continues monitoring were admitted in High Dependency Unit (HDU) of the surgical department. Out of 275 patients 165 were admitted through emergency room after some surgical operation, whereas 115 patients are from those who were electively operated and shifted in HDU for management and monitoring due to some anaesthesia related complications or comorbidities. Conclusion: The High Dependency Unit care promotes efficient and effective care by increasing the flexibility of patient triage, utilizing resources efficiently, and providing cost effective timely care to serious surgical patient admitted in surgical wards. Key words:Intensive Care, Postop Care, Recovery, Critical Illness, HDU Mortality. Article Citation: Jahan S, Aziz S, Ateeq M, Asif M. High dependency unit; impact of care on outcome of surgical patients an experience of surgical unit of district teaching hospital

Objective: To analyze the role of damage control in surgery in severely injured and polytrauma patients. D e s i g n:Descriptive study. S e t t i n g : Surgical unit of District Headquarter (teaching) Hospital, Rawalpindi. P e r i o d : January 2000 to December 2007.Patients a n d m e t h o d s : This study included 28 severely injured patients who presented in the accident and emergency department ofDistrict Headquarters (teaching) Hospital, Rawalpindi. These patients were unstable because of life threatening hemorrhage following someblunt or penetrating trauma. After immediate shifting to operation theater, resuscitation and operative intervention was done simultaneously.Different procedures of damage control surgery like abdominal packing for hepatic and pelvic trauma, major vascular ligation for vascularinjuries of neck and extremities were adopted in phase I. In phase II patients were managed in ITC for coagulopathy and hypothermia.Definitive treatment was done in Phase III after 24-72 hours once patients got stable. R e s u l t s : Total 28 patients included in the study. In18 patients abdominal packing for hepatic injury (n=11) and pelvic fractures (n=7) was done. Major vascular ligations in n=11 and temporaryintestinal clamping in n=1 patient. Planned re-exploration after 24-72 hours in n=16 and unplanned re-exploration within 24 hours in n=5patients was done. Complications included ongoing hemorrhage (n=5), coagulopathy (n=2), controlled biliary fistula (n=1), abdominalcompartment syndrome (n=1), cerebral ischemia (n=1) and gangrene of abdominal wall (n=1). Two patients died.

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