损伤控制手术
医学
损伤控制
重症监护室
战场
重症监护医学
凝血病
剖腹手术
复苏
外科
重症监护
医疗急救
历史
古代史
出处
期刊:Critical Care Medicine
[Ovid Technologies (Wolters Kluwer)]
日期:2008-07-01
卷期号:36 (Suppl): S304-S310
被引量:134
标识
DOI:10.1097/ccm.0b013e31817e2854
摘要
Background: Although the use of damage control surgery for blunt and penetrating injury has been widely reported and defined, the use of damage control surgery on the battlefield (combat damage control surgery) has not been well detailed. Discussion: Damage control surgery is now well established as the standard of care for severely injured civilian patients requiring emergent laparotomy in the United States. The civilian damage control paradigm is based on a "damage control trilogy." This trilogy comprises an abbreviated operation, intensive care unit resuscitation, and a return to the operating room for the definitive operation. The goal of damage control surgery and the triology is avoidance of irreversible physiological insult termed the lethal triad. The lethal triad comprises the vicious cycle of hypothermia, acidosis, and coagulopathy. Although the damage control model involves the damage control trilogy, abbreviated operation, intensive care unit resuscitation, and definitive operation, all in the same surgical facility, the combat damage control paradigm must incorporate global evacuation through several military surgical facilities and involves up to ten stages to allow for battlefield evacuation, surgical operations, multiple resuscitations, and transcontinental transport. Summary: Combat damage control surgery represents many unique challenges for those who care for the severely injured patients in a combat zone.
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