Abstract
The term “damage control” is rooted in Navy history as the way to approach shipboard battle damage. Essentially, it applied to quick measures aimed at stopping flood waters from rushing in and sinking a ship. In surgery, the term has come to mean application of expedient approaches to stemming exsanguinating hemorrhage and controlling contamination, in the physiologically deranged patient, to the point where resuscitation can occur. Trauma surgery typically has four stages. First is hemorrhage control, second is contamination control, third is evaluation or diagnosis, and fourth is reconstruction. Damage control surgery mandates the first two stages but defers the third and fourth stages till a more appropriate time and place. In civilian damage control, it was originally developed as a temporizing measure that provides time for restoration of normal physiology and, later, normal anatomy. In this chapter, we look to apply damage control surgery methods to the combat trauma environment. In this setting, the logistics are often completely different than in civilian trauma centers and are often done not for physiology restoration but due to the logistics and resources of the combat environment.
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References
Eastridge BJ, et al. Death on the battlefield (2001–2011): implications for the future of combat casualty care. J Trauma Acute Care Surg. 2012;73(6 Suppl 5):S431–7.
Garner J, et al. Mechanisms of injury by explosive devices. Anesthesiol Clin. 2007;25(1):147–60.
Belmont PJ Jr, et al. Incidence and epidemiology of combat injuries sustained during “the surge” portion of operation Iraqi Freedom by a US Army brigade combat team. J Trauma. 2010;68(1):204–10.
Mabry RL, et al. United States Army Rangers in Somalia: an analysis of combat casualties on an urban battlefield. J Trauma. 2000;49(3):515–28.
Chandler H, et al. Extremity injuries sustained by the UK military in the Iraq and Afghanistan conflicts: 2003–2014. Injury. 2017;48(7):1439–43.
Blackbourne LH, et al. Military medical revolution: prehospital combat casualty care. J Trauma Acute Care Surg. 2012;73(6):S372–7.
TCCC guidelines. https://www.jsomonline.org/TCCC/TCCC%20Guidelines%20for%20Medical%20Personnel%20170131%20Final.pdf. Accessed 6 Sept 2017.
Hodgetts TJ, et al. Putting role 1 first: the role 1 capability review. J R Army Med Corps. 2012;158(3):162–70.
Wheatley RJ. The role 1 capability review: mitigation and innovation for Op Herrick 18 and into contingency. J R Army Med Corps. 2014;160(3):211–2.
Chambers LW, et al. The experience of the US Marine Corps’ Surgical Shock Trauma Platoon with 417 operative combat casualties during a 12 month period of operation Iraqi Freedom. J Trauma. 2006;60(6):1155–64.
Brisebois CR, et al. The role 3 multinational medical unit at Kandahar Airfield 2005-2010. Can J Surg. 2011;54(6):S124–9.
Beckett A, et al. Multidisciplinary trauma team care in Kandahar, Afghanistan: current injury patterns and care practices. Injury. 2012;43(12):2072–7.
Kotwal RS, et al. The effect of a Golden Hour policy on the morbidity and mortality of combat casualties. JAMA Surg. 2016;151(1):15–24.
Bennett BL, et al. Management of external hemorrhage in Tactical Combat Casualty Care: chitosan-based hemostatic gauze dressings—TCC guidelines- change 13-05. J Spec Oper Med. 2014;14(3):40–57.
Beekley AC, et al. Prehospital tourniquet use in Operation Iraqi Freedom: effect on hemorrhage control and outcomes. J Trauma. 2008;64(2 Suppl):S28–37.
Tactical Combat Casualty Care Guidelines for Medical Personnel, January 31, 2017. http://www.usaisr.amedd.army.mil/pdfs/TCCCGuidelinesforMedicalPersonnel170131Final.pdf. Accessed 30 April 2018.
King DR, et al. Tourniquet use at the Boston Marathon bombing: lost in translation. J Trauma Acute Care Surg. 2015;78(3):594–9.
Lakstein D, et al. Tourniquets for hemorrhage control on the battlefield: a 4-year accumulated experience. J Trauma. 2003;54(5 Suppl):S221–5.
Kragh JF, et al. Minor morbidity with emergency tourniquet use to stop bleeding in severe limb trauma: research, history, and reconciling advocates and abolitionists. Mil Med. 2007;176(7):817–3.
Kragh JF, et al. Junctional tourniquet training experience. J Spec Oper Med. 2015;15(3):20–30.
Klotz JK, et al. First case report of SAM(r) Junctional tourniquet use in Afghanistan to control inguinal hemorrhage on the battlefield. J Spec Oper Med. 2014;14(2):1–5.
Holcomb JB, et al. Damage control resuscitation. J Trauma. 2007;62(6 Suppl):S36–7.
Cotton BA, et al. Damage control resuscitation is associated with a reduction in resuscitation volumes and improvement in survival in 390 damage control laparotomy patients. Ann Surg. 2011;254(4):598–605.
Morrison JJ, et al. Military application of tranexamic acid in trauma emergency resuscitation (MATTERs) study. Arch Surg. 2012;147(2):113–9.
Joseph B, et al. Assessing the efficacy of prothrombin complex concentrate in multiply injured patients with high-energy pelvic and extremity fractures. J Orthop Trauma. 2016;30(12):653–8.
Spinella PC, et al. Resuscitation and transfusion principles for traumatic hemorrhagic shock. Blood Rev. 2011;23(6):231–40.
Damage control resuscitation. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/DamageControlResuscitation_03Feb2017.pdf. Accessed 6 Oct 2017.
Fresh whole blood transfusion. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/Fresh_Whole_Blood_Transfusion_24_Oct_12.pdf. Accessed 6 Oct 2017.
Parker PJ, et al. Casualty evacuation timelines: an evidence-based review. J R Army Med Corps. 2007;153(4):274–7.
Hypothermia prevention, monitoring, and management. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/Hypothermia_Prevention_20_Sep_12.pdf. Accessed 6 Oct 2017.
Pain, anxiety, and delirium. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/Pain_Anxiety_Delirium_13Mar2017.pdf. Accessed 6 Oct 2017.
Lubin D, et al. Modified Veress needle decompression of tension pneumothorax: a randomized crossover animal study. J Trauma Acute Care Surg. 2013;75(6):1071–5.
Martin M, et al. Does needle thoracostomy provide adequate and effective decompression of tension pneumothorax? J Trauma Acute Care Surg. 2012;73(6):1412–7.
Butler FK, et al. Management of open pneumothorax in tactical combat casualty care: TCCC guidelines change 13-02. J Spec Oper Med. 2013;13(3):81–6.
Kotwal RS, et al. The effect of a golden hour policy on the morbidity and mortality of combat casualties. JAMA Surg. 2016;151(1):15–24.
American College of Surgeons, Committee on Trauma, “Advanced Trauma Life Support, 9th edition”.Chicago, Illinois, American College of Surgeons, 2013.
Hathaway E, et al. Exploratory laparotomy for proximal vascular control in combat-related injuries. Mil Med. 2016;181(5 Suppl):247–52.
Dismounted complex blast injury: report of the army dismounted complex blast injury task force. 2011. http://armymedicine.mil/Documents/DCBI-Task-Force-Report-Redacted-Final.pdf. Accessed 6 Oct 2017.
Andersen RC, et al. Dismounted complex blast injury. J Surg Orthop Adv. 2012;21(1):2–7.
Rodriguez CJ, et al. Risk factors associated with invasive fungal infections in combat trauma. Surg Infect. 2014;15(5):521–6.
Radowsky JS, et al. A surgeon’s guide to obtaining hemorrhage control in combat-related dismounted lower extremity injury. Mil Med. 2016;181(10):1300–4.
Advanced Surgical Exposures in Trauma (ASSET). https://www.facs.org/quality-programs/trauma/education/asset. Accessed 6 Oct 2017.
Brenner M, et al. Basic endovascular skills for trauma course: bridging the gap between endovascular techniques and the acute care surgeon. J Trauma Acute Care Surg. 2014;77(2):286–91.
Reva VA, et al. Field and en route REBOA: a feasible military reality? J Trauma Acute Care Surg. 2017;83(1):S170–6.
Fisher AD, et al. The role 1 resuscitation team and resuscitative endovascular balloon occlusion of the aorta. J Spec Oper Med. 2017;17(2):65–73.
Demetriades D, et al. Penetrating injuries to the subclavian and axillary vessels. J Am Coll Surg. 1999;188(3):290–5.
Sciarretta JD, et al. Subclavian vessel injuries: difficult anatomy and difficult territory. Eur J Trauma Emerg Surg. 2011;37(5):439.
Owens BD, et al. Comparison of irrigation solutions and devices in a contaminated musculoskeletal wound survival model. J Bone Joint Surg Am. 2009;91(1):92–8.
Vascular injury. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/Vascular_Injury_12_Aug_2016.pdf. Accessed 8 Sept 2017.
Acute extremity compartment syndrome (CS) and the role of fasciotomy in extremity war wounds. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/Acute_Compartment_Syndrome-Fasciotomy_25Jul2016.pdf. Accessed 8 Sept 2017.
Filiberto DM, et al. Preperitoneal pelvic packing: technique and outcomes. Int J Surg. 2016;33(Pt B):222–4.
Urologic trauma management. Joint trauma system clinical practice guidelines. http://www.usaisr.amedd.army.mil/cpgs/Urologic_Trauma_Management_2_Apr_12.pdf. Accessed 8 Sept 2017.
Eskridge SL, et al. Injuries from combat explosions in Iraq: injury type, location, and severity. Injury. 2012;43(10):1678–82.
Blunt abdominal trauma, splenectomy, and post-splenectomy vaccination. Joint trauma system clinical practice guideline. http://www.usaisr.amedd.army.mil/cpgs/Blunt_Abdominal_Splenectomy_Vacc_12_Aug_2016.pdf. Accessed 8 Sept 2017.
Burlew CC, et al. Sew it Up! A Western Trauma Association multi-institutional study of enteric injury management in the post-injury open abdomen. J Trauma. 2011;70(2):273–7.
Sullivan PS, et al. Outcome of ligation of the inferior vena cava in the modern era. Am J Surg. 2010;199(4):500–6.
Lauerman MH, et al. Delayed interventions and mortality in trauma damage control laparotomy. Surgery. 2016;160(6):1568–75.
Keneally R, et al. Thoracic trauma in Iraq and Afghanistan. J Trauma Acute Care Surg. 2013;74(5):1292–7.
Inaba K, et al. Does size matter? A prospective analysis of 28-32 versus 36-40 French chest tube size in trauma. J Trauma Acute Care Surg. 2012;72(2):422–7.
Alfici R, et al. Total pulmonectomy in trauma: a still unresolved problem- our experience and review of the literature. Am Surg. 2007;73(4):381–4.
Wilson A, et al. The pulmonary hilum twist as a thoracic damage control procedure. Am J Surg. 2003;186(1):49–52.
Halonen-Waras J, et al. Traumatic pneumonectomy: a viable option for patients in extremis. Am Surg. 2011;77(4):493–7.
Bien T, et al. Transportable extracorporeal lung support for rescue of severe respiratory failure in combat casualties. J Trauma Acute Care Surg. 2012;73(6):1450–6.
Allan PF, et al. The introduction of extracorporeal membrane oxygenation to aeromedical evacuation. Mil Med. 2011;176(8):932–7.
Fang R, et al. Closing the “care in the air” capability gap for severe lung injury: the Landstuhl Acute Lunge Rescue Team and extracorporeal lung support. J Trauma. 2011;71(1 Suppl):S91–7.
Rhee P, et al. Early autologous fresh whole blood transfusion leads to less allogeneic transfusions and is safe. J Trauma Acute Care Surg. 2015;78(4):729–34.
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Rodriguez, C., Rhee, P. (2018). Damage Control Surgery: Military. In: Duchesne, J., Inaba, K., Khan, M. (eds) Damage Control in Trauma Care. Springer, Cham. https://doi.org/10.1007/978-3-319-72607-6_3
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DOI: https://doi.org/10.1007/978-3-319-72607-6_3
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