Hospital Pablo Tobon Uribe, Department of Surgery, Medellin, Colombia.
Universidad de Antioquia, Department of Surgery, Medellin, Colombia.
Colomb Med (Cali). 2021 Jun 30;52(2):e4154805. doi: 10.25100/cm.v52i2.4805. eCollection 2021 Apr-Jun.
Damage control has well-defined steps. However, there are still controversies regarding whom, when, and how re-interventions should be performed. This article summarizes the Trauma and Emergency Surgery Group (CTE) Cali-Colombia recommendations about the specific situations concerning second interventions of patients undergoing damage control surgery. We suggest packing as the preferred bleeding control strategy, followed by unpacking within the next 48-72 hours. In addition, a deferred anastomosis is recommended for correction of intestinal lesions, and patients treated with vascular shunts should be re-intervened within 24 hours for definitive management. Furthermore, abdominal or thoracic wall closure should be attempted within eight days. These strategies aim to decrease complications, morbidity, and mortality.
损伤控制有明确的步骤。然而,关于谁、何时以及如何进行再次干预仍然存在争议。本文总结了创伤和急诊外科学组(CTE)卡利-哥伦比亚的建议,这些建议涉及到接受损伤控制手术的患者的具体二次干预情况。我们建议使用填塞作为首选的出血控制策略,然后在接下来的 48-72 小时内进行拆除。此外,建议对肠损伤进行延迟吻合术,而接受血管分流术的患者应在 24 小时内进行再次干预以进行确定性治疗。此外,应在八天内尝试进行腹部或胸壁闭合。这些策略旨在减少并发症、发病率和死亡率。