Damage Control Thoracotomy: A Systematic Review of Techniques and Outcomes

Douglas, Anthony; Puzio, Thaddeus J.; Murphy, Patrick; Menard, Laura; Meagher, Ashley D.

doi:10.1016/j.injury.2020.12.020

Cited by 8 publications

(6 citation statements)

References 29 publications

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“…identified 130 damage control thoracotomy patients with overall mortality rate of 33% [34]. The high mortality rate correlates with the critically injured, severe shock states these patients often present with, but compares favorably with the historical mortality rates of 79-99% for resuscitative thoracotomy [35,36].…”

Section: Key Pointsmentioning

confidence: 97%

“…Mean follow up at 34 months also showed no late mortality or need for re-operative thoracotomy. Following the publication of other smaller series, a systematic review by Douglas et al of similarly defined damage control thoracotomy included 7 studies and identified 130 damage control thoracotomy patients with overall mortality rate of 33% [34]. The high mortality rate correlates with the critically injured, severe shock states these patients often present with, but compares favorably with the historical mortality rates of 79–99% for resuscitative thoracotomy [35,36].…”

Section: Damage Control Across Trauma Subspecialitiesmentioning

confidence: 99%

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Damage control surgery: old concepts and new indications

Chung,

Scalea

2023

Current Opinion in Critical Care

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Purpose of review While the principles of damage control surgery - rapid hemorrhage and contamination control with correction of physiologic derangements followed by delayed definitive reconstruction - have remained consistent, forms of damage control intervention have evolved and proliferated dramatically. This review aims to provide a historic perspective of the early trends of damage control surgery as well as an updated understanding of its current state and future trends. Recent findings Physiologically depleted patients in shock due to both traumatic and nontraumatic causes are often treated with damage control laparotomy and surgical principles. Damage control surgery has also been shown to be safe and effective in thoracic and orthopedic injuries. Damage control resuscitation is used in conjunction with surgical source control to restore patient physiology and prevent further collapse. The overuse of damage control laparotomy, however, is associated with increased morbidity and complications. With advancing technology, catheter- and stent-based endovascular modalities are playing a larger role in the resuscitation and definitive care of patients. Summary Optimal outcome in the care of the most severely injured patients requires judicious use of damage control surgery supplemented by advancements in resuscitation and surgical adjuncts.

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Section: Key Pointsmentioning

confidence: 97%

Section: Damage Control Across Trauma Subspecialitiesmentioning

confidence: 99%

Damage control surgery: old concepts and new indications

Chung,

Scalea

2023

Current Opinion in Critical Care

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“…56 Optimal damage-control surgical principles, including packing and temporary thoracic closure, are still being defined. 109…”

Section: Thoracic Injurymentioning

confidence: 99%

American Association for the Surgery of Trauma/American College of Surgeons Committee on Trauma: Clinical protocol for damage-control resuscitation for the adult trauma patient

LaGrone,

Stein,

Cribari

et al. 2023

J Trauma Acute Care Surg

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Damage control resuscitation in the care of critically injured trauma patients aims to limit blood loss and prevent and treat coagulopathy by combining early definitive hemorrhage control, hypotensive resuscitation and early and balanced use of blood products (hemostatic resuscitation) and the use of other hemostatic agents. This clinical protocol has been developed to provide evidence-based recommendations for optimal damage control resuscitation in the care of trauma patients with hemorrhage. LEVEL OF EVIDENCE Therapeutic/Care Management; Level V. TYPE: Algorithms / Guidelines / Clinical Protocol

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“…It is commonly used in damage control surgery for thoracic trauma. 4 A variety of approaches exist spanning from Esmarch bandaging, Bogota bag, simple skin closure with or without active thoracic cage splinting or intrathoracic gauge packing. Indications for delayed chest closure in transplantation include acute lung oedema, oversize allograft, coagulopathy, haemodynamic instability or impaired arterial partial pressure of O2/ Fraction of inspired O2 ratio (PaO2/FiO2).…”

Section: Descriptionmentioning

confidence: 99%

“…Delayed chest closure is a technique used to avoid thoracic compartment syndrome causing haemodynamic instability and desaturation. It is commonly used in damage control surgery for thoracic trauma 4. A variety of approaches exist spanning from Esmarch bandaging, Bogota bag, simple skin closure with or without active thoracic cage splinting or intrathoracic gauge packing.…”

Section: Descriptionmentioning

confidence: 99%