Damage control surgery. Fundaments and results. A four years review of cases in a public hospital of Uruguay

Abstract

Trauma is the pandemic of the new millennium and the third leading cause of death in our country,
it remains the leading cause of death in people under 40 years. The damage control surgery emerged
with the aim of improving the poor results with traditional surgical approaches in severe abdominal trauma. This new strategy has been shown to produce improvements in survival rates. We reviewed
all patients with traumatic injury who underwent damage control surgery from March 2010 to July
2014. This is a descriptive, retrospective, observational case series study done at the Maciel Hospital
by review of medical records, operative data descriptions and length stay in an Intensive Care Unit. We
obtained data from 15 patients who underwent damage control surgery: 12 men (80%) and 3 women
(20%). Mean age at presentation was 30.2 years. All had hemodynamic instability when they arrived
at the emergency room and were polytranfused during surgery. The parietal closure was achieved in
11 patients. The average days at laparostomy was 12.6 days. The overall mortality of the series was
46.66%. The main cause of death was refractory shock and Multiple Organ Failure while in 2 patients
in whom the parietal closure was achieved, mortality was due to severe Traumatic Brain Injury and
maintained sepsis associated to suture leakage.