创伤患者管理中损伤控制的创新史：1902 - 2016年

History of the Innovation of Damage Control for Management of Trauma Patients: 1902-2016.

作者信息

Roberts Derek J, Ball Chad G, Feliciano David V, Moore Ernest E, Ivatury Rao R, Lucas Charles E, Fabian Timothy C, Zygun David A, Kirkpatrick Andrew W, Stelfox Henry T

机构信息

*Department of Surgery, University of Calgary, Calgary, Alberta, Canada †Regional Trauma Program, Calgary, Alberta, Canada ‡Department of Oncology, University of Calgary and the Foothills Medical Centre, Calgary, Alberta, Canada §Department of Surgery, Indiana University Medical Center, Indianapolis, IN ¶Department of Surgery, University of Colorado Denver, Denver, CO ||Department of Surgery, Virginia Commonwealth University, Richmond, VA **Department of Surgery, Wayne State University, Detroit, MI ††Department of Surgery, University of Tennessee Health Science Center, Memphis, TN ‡‡Division of Critical Care Medicine, University of Alberta, Edmonton, Alberta, Canada §§Department of Critical Care Medicine, University of Calgary and the Foothills Medical Centre, Calgary, Alberta, Canada ¶¶Department of Medicine, University of Calgary, Calgary, Alberta, Canada ||||Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

出版信息

Ann Surg. 2017 May;265(5):1034-1044. doi: 10.1097/SLA.0000000000001803.

DOI:10.1097/SLA.0000000000001803

PMID:27232248

Abstract

OBJECTIVE

To review the history of the innovation of damage control (DC) for management of trauma patients.

BACKGROUND

DC is an important development in trauma care that provides a valuable case study in surgical innovation.

METHODS

We searched bibliographic databases (1950-2015), conference abstracts (2009-2013), Web sites, textbooks, and bibliographies for articles relating to trauma DC. The innovation of DC was then classified according to the Innovation, Development, Exploration, Assessment, and Long-term study model of surgical innovation.

RESULTS

The "innovation" of DC originated from the use of therapeutic liver packing, a practice that had previously been abandoned after World War II because of adverse events. It then "developed" into abbreviated laparotomy using "rapid conservative operative techniques." Subsequent "exploration" resulted in the application of DC to increasingly complex abdominal injuries and thoracic, peripheral vascular, and orthopedic injuries. Increasing use of DC laparotomy was followed by growing reports of postinjury abdominal compartment syndrome and prophylactic use of the open abdomen to prevent intra-abdominal hypertension after DC laparotomy. By the year 2000, DC surgery had been widely adopted and was recommended for use in surgical journals, textbooks, and teaching courses ("assessment" stage of innovation). "Long-term study" of DC is raising questions about whether the procedure should be used more selectively in the context of improving resuscitation practices.

CONCLUSIONS

The history of the innovation of DC illustrates how a previously abandoned surgical technique was adapted and readopted in response to an increased understanding of trauma patient physiology and changing injury patterns and trauma resuscitation practices.

摘要

目的

回顾损伤控制（DC）用于创伤患者管理的创新历程。

背景

DC是创伤护理领域的一项重要进展，为外科创新提供了有价值的案例研究。

方法

我们检索了文献数据库（1950 - 2015年）、会议摘要（2009 - 2013年）、网站、教科书及参考文献，以查找与创伤DC相关的文章。然后根据外科创新的创新、发展、探索、评估和长期研究模型对DC的创新进行分类。

结果

DC的“创新”源于治疗性肝填塞的应用，这一做法在二战后因不良事件而被摒弃。随后它“发展”为采用“快速保守手术技术”的简化剖腹术。后续的“探索”使得DC应用于越来越复杂的腹部损伤以及胸部、周围血管和骨科损伤。随着DC剖腹术使用的增加，损伤后腹腔间隔室综合征的报道增多，并且开始预防性使用开放腹腔以预防DC剖腹术后的腹腔内高压。到2000年，DC手术已被广泛采用，并在外科期刊、教科书和教学课程中被推荐使用（创新的“评估”阶段）。对DC的“长期研究”引发了关于在改进复苏措施的背景下该手术是否应更有选择性地使用的问题。