Department of Orthopaedic Trauma Surgery, Medical School of the RWTH Aachen University, Aachen, Germany.
Curr Opin Crit Care. 2012 Dec;18(6):647-50. doi: 10.1097/MCC.0b013e328359fd57.
There is still an ongoing debate whether damage control orthopedics (DCO) or other treatment strategies should be favored in the treatment of multiply injured patients. This review gives an overview of the current literature concerning this important question in the treatment of severely injured patients.
Several studies could show that DCO can reduce the inflammatory burden due to surgery (second hit). The only randomized study showed a benefit for borderline patients treated by DCO in comparison to early total care. Other studies showed advantages for early care treatment in similar patients.
In severely injured patients, DCO should be considered. On the other hand, there is still a lack of randomized studies for a more precise characterization of the patients who benefit from DCO treatment.
目前仍存在关于损伤控制骨科（DCO）或其他治疗策略在多发伤患者治疗中更具优势的争论。本综述概述了关于严重创伤患者治疗中这一重要问题的现有文献。
多项研究表明，DCO 可减少手术引起的炎症负担（二次打击）。唯一的一项随机研究显示，与早期全面治疗相比，DCO 治疗的边缘患者获益。其他研究表明，对于类似患者，早期治疗具有优势。
在严重创伤患者中，应考虑采用 DCO。另一方面，对于更精确地确定从 DCO 治疗中获益的患者，仍缺乏随机研究。
