Damage control surgery for abdominal trauma

Masoud M. Bashir, Fikri M. Abu-Zidan

Research output: Contribution to journalReview articlepeer-review

26 Citations (Scopus)


Objective: To review the physiology, indications, technical aspects, morbidity, and mortality of damage control surgery. Design: Retrospective study of published papers. Setting: Teaching hospital, United Arab Emirates. Interventions: A MEDLINE search on damage control surgery for the years 1981-2001. Further articles were retrieved from the references of the original articles. Results: The indications for damage control surgery are: the need to terminate a laparotomy rapidly in an exsanguinating, hypothermic patient who had developed a coagulopathy and who is about to die on the operating table; inability to control bleeding by direct haemostasis; and inability to close the abdomen without tension because of massive visceral oedema and a tense abdominal wall. The principles of damage control surgery are: Phase I: laparotomy to control haemorrhage by packing; shunting, or balloon tamponade, or both; control of intestinal spillage by resection or ligation of damaged bowel, or both. Phase II: physiological resuscitation to correct hypothermia, metabolic acidosis, and coagulopathy. Phase III: planned reoperation for definitive repair. Damage control surgery is appropriate in a small number of critically ill patients who are likely to require substantial hospital resources; it has a high mortality (mean 45%, range (10%-69%). Conclusion: Damage control surgery offers a simple effective alternative to the traditional surgical management of complex or multiple injuries in critically injured patients. Phases I and II can be done at a rural hospital before transfer to a major trauma centre for definitive repair.

Original languageEnglish
Pages (from-to)8-13
Number of pages6
JournalEuropean Journal of Surgery, Supplement
Issue number588
Publication statusPublished - 2003


  • Coagulopathy
  • Damage control
  • Hypothermia
  • Surgery
  • Trauma

ASJC Scopus subject areas

  • Surgery


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