Damage Control Surgery: orientamenti attuali

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COD: 081-084 Categorie: ,

Gregorio Tugnoli, Marco Casali, Silvia Villani, Andrea Biscardi, Giovanni Sinibaldi, Franco Baldoni

Ann. Ital. Chir., 2007; 78: 81-84

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AIM OF THE STUDY: To evaluate our experience in the treatment of complex abdominal injuries with the principles of
Damage Control Surgery (DCS).
METHOD: A retrospective review was conducted of 55 patients with multiple abdominal injuries and severe haemorrhage
induced hypothermia and acidosis admitted to the «Ospedale Maggiore Trauma Center» in Bologna from 1989 to June
2005.
RESULTS: All the patients but one had major blunt trauma. Mean age was 40.1; mean ISS 42; mean RTS 4.11; extimated
loss of blood was greater than 4000 ml. Packing provide definitive control of bleeding in 44 patients but 10
had recurrent bleeding or bleeding from different injuries such as bone fractures and required further surgery (2) or arterial
embolization (8). Twenty eights patients (50.9%) died.Survival was strongly associated with the ISS, GCS, the loss
of blood and acidosis.
CONCLUSION: The Authors concluded that in selected circumstances the traditional approach to severe abdominal injuries
is not appropiate. In this situation, alternative and aggressive treatment such as the Damage Control Surgery has
been recommended as the procedure of choice.

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