Article Text

Download PDFPDF
3 Damage control surgery in a regional trauma centre – defining the population: a pilot study
  1. Matthew J Burton
  1. Surgeon Lieutenant, Royal Navy

Abstract

Introduction Trauma has a major disease burden, by causing physiological disruption.1 Damage Control Surgery (DCS) minimises physiological disruption.2 3 The demographics of patients who undergo DCS surgery within our institution are unknown. This study aims to characterise our DCS cohort and potential for prospective study.

Methods Our hospital has a DCS protocol.4 This ensures the appropriate patients are safely and promptly transferred to a prepared operating theatre. All ORSOS data were captured from Nov 2017 – Sep 2019. Data was reviewed, and demographics analysed.

Results The DCS protocol was put on stand-by 42 times and activated in 21. Patient data was held for 38 cases, 30 male and 8 female, median age 37 years.

Median Injury Severity Score was 29, with patients sustaining injuries from a range of mechanisms, figure 1. Median inpatient stay was 12 days, with a 29% 30-day mortality.

Together this shows that despite prompt surgical intervention, a young patient cohort carries a significant mortality.

Conclusions We have established the demographics of those who trigger DCS protocol use in a regional trauma centre. The resultant database enables prospective data collection for future DCS patients. Such data will afford our region a greater understanding of the DCS population.

References

  1. Polinder S, Haagsma JA, Toet H, van Beeck EF. Epidemiological burden of minor, major and fatal trauma in a national injury pyramid. British journal of surgery 2012 Jan;99(S1):114–20.

  2. Schreiber MA. Damage control surgery. Critical Care Clinics 2004 Jan 1;20(1):101–18.

  3. Rotondo MF, Schwab CW, McGonigal MD, Fruchterman TM, Kauder DR, Latenser BA, Angood PA. ‘Damage control’: an approach for improved survival in exsanguinating penetrating abdominal injury. The Journal of Trauma 1993 Sep;35(3):375–82.

  4. Moor P, Droog S, Adams S. Damage Control Surgery (Online). Peninsula Trauma Network. University Hospital Plymouth. 2016 Feb [2019 December]. Available from: https://www.plymouthhospitals.nhs.uk/download.cfm?doc=docm93jijm4n3410.pdf&ver=4326

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.