Rubiano Andres M, Maldonado Miguel, Montenegro Jorge, Restrepo Claudia M, Khan Ahsan Ali, Monteiro Ruy, Faleiro Rodrigo M, Carreño José N, Amorim Robson, Paiva Wellingson, Muñoz Erick, Paranhos Jorge, Soto Alvaro, Armonda Rocco, Rosenfeld Jeffrey V
Institute of Neurosciences and Neurosurgery, El Bosque University, Bogotá, Colombia; NIHR Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK; INUB MEDITECH Research Group, MEDITECH Foundation, Cali, Colombia; MEDITECH Foundation, Cali Valle, Colombia.
School of Medicine, Central Military Hospital, Nueva Granada Military University, Bogota, Colombia.
World Neurosurg. 2019 May;125:e82-e93. doi: 10.1016/j.wneu.2019.01.005. Epub 2019 Jan 16.
The aim of the present review was to describe the evolution of the damage control concept in neurotrauma, including the surgical technique and medical postoperative care, from the lessons learned from civilian and military neurosurgeons who have applied the concept regularly in practice at military hospitals and civilian institutions in areas with limited resources.
The present narrative review was based on the experience of a group of neurosurgeons who participated in the development of the concept from their practice working in military theaters and low-resources settings with an important burden of blunt and penetrating cranial neurotrauma.
Damage control surgery in neurotrauma has been described as a sequential therapeutic strategy that supports physiological restoration before anatomical repair in patients with critical injuries. The application of the concept has evolved since the early definitions in 1998. Current strategies have been supported by military neurosurgery experience, and the concept has been applied in civilian settings with limited resources.
Damage control in neurotrauma is a therapeutic option for severe traumatic brain injury management in austere environments. To apply the concept while using an appropriate approach, lessons must be learned from experienced neurosurgeons who use this technique regularly.
本综述的目的是描述神经创伤中损伤控制概念的演变，包括手术技术和术后医疗护理，这些经验来自在资源有限地区的军事医院和民用机构中经常在实践中应用该概念的 civilian 和军事神经外科医生。
本叙述性综述基于一组神经外科医生的经验，他们从在军事战区和资源匮乏地区工作的实践中参与了该概念的发展，这些地区钝性和穿透性颅脑神经创伤负担较重。
神经创伤中的损伤控制手术被描述为一种序贯治疗策略，用于支持重伤患者在进行解剖修复前的生理恢复。自1998年的早期定义以来，该概念的应用已经有所发展。当前的策略得到了军事神经外科经验的支持，并且该概念已在资源有限的民用环境中得到应用。
神经创伤中的损伤控制是在严峻环境中管理严重创伤性脑损伤的一种治疗选择。为了在使用适当方法的同时应用该概念，必须向经常使用该技术的经验丰富的神经外科医生学习。
