The Concept of Damage Control Laparotomy

Abstract

Over the past 25 years, principles of damage control Laparotomy have saved many lives. Quick recognition of injuries and immediate transfer to operating room are essential. Patients with polytrauma have substantial haemorrhage and go into a vicious cycle of death (hypothermia, coaugulopathy and acidosis). Prior to surgery, adequate resuscitation helps to improve both intra and post-operative mortality. And the focus is on control of bowel contamination and haemorrhage. Once achieved, patient is resuscitated in ICU setup to optimize physiology. Adequate hydration, blood transfusion, re-warming of the patient and other supportive measures are taken to arrest the ongoing cycle of coagulation, hypothermia and metabolic acidosis. Later, patient is moved to theatre for definitive management of injuries. Improvement in patient outcome has been reported by an increased understanding of damage control and the anatomical and physiological steps taken to improve the outcomes.