Damage control laparotomy: a vital tool once overused

The Journal of Trauma
Guillermo HigaPeter Rhee

Abstract

Trauma surgery is in constant evolution as is the use of damage control laparotomy (DCL). The purpose of this study was to report the change in usage of DCL over time and its effect on outcome. Trauma patients requiring laparotomies during a 3-year (2006-2008) period were reviewed. DCL was defined as laparotomy when fascia was not closed at the first operation. There were 14,534 trauma patients evaluated, and 843 laparotomies were performed on 532 patients during the study period. The number of patients requiring open laparotomies slightly increased while the demographics and Injury Severity Score were similar during the study period. The number of patient requiring DCL significantly decreased from 36.3% (53 of 146) in 2006 to 8.8% (15 of 170) in 2008 (p < 0.001). During this same time period, the mortality rate for patients requiring open laparotomy significantly decreased from 21.9% in 2006 to 12.9% in 2008 (p = 0.05). The decreased use of DCL resulted in a 33.3% reduction in the number of laparotomies performed. The decrease in average costs and charges is projected to result in savings of $2.2 million and $5.8 million, respectively. The use of DCL was significantly decreased by 78% during the study with significantly improv...Continue Reading

References

May 1, 1983·Annals of Surgery·H H StoneR J Mullins
Dec 5, 1998·World Journal of Surgery·E E MooreW L Biffl
Nov 22, 2000·The Journal of Trauma·M B ShapiroM F Rotondo
Jan 6, 2001·Journal of the Royal Army Medical Corps·D M BowleyK D Boffard
Feb 13, 2002·American Journal of Surgery·L N TremblayG S Rozycki
Jan 17, 2004·ANZ Journal of Surgery·Susan J Neuhaus, Justin R Bessell
Jan 6, 2006·The Journal of Trauma·Richard S MillerAddison K May
Jul 18, 2008·Critical Care Medicine·Lorne H Blackbourne
Jul 16, 2008·Scandinavian Journal of Infectious Diseases·Wen-Bo ZhangJie-Shou Li
Aug 13, 2008·The Journal of Trauma·Jordan A WeinbergLoring W Rue
Oct 24, 2008·The American Surgeon·Pedro G R TeixeiraDemetrios Demetriades
Dec 20, 2008·American Journal of Surgery·Frederick A MooreUNKNOWN StO2 Study Group
Feb 14, 2009·The American Surgeon·Pedro G R TeixeiraDemetrios Demetriades
Mar 12, 2009·The Journal of Trauma·Pedro G R TeixeiraPeter Rhee
Apr 4, 2009·World Journal of Surgery·Zsolt J BaloghFrederick A Moore

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Citations

Nov 19, 2011·International Journal of Critical Illness and Injury Science·Jeremy M Hsu, Tam N Pham
Oct 7, 2011·World Journal of Surgery·R LatifiP M Rhee
Aug 2, 2012·The Surgical Clinics of North America·Jonathan J Morrison, Todd E Rasmussen
Jun 12, 2012·The Journal of Surgical Research·Talia A SorrentinoClay Cothren Burlew
Aug 2, 2012·The Surgical Clinics of North America·John ChovanesTimothy C Nunez
Jan 13, 2016·American Journal of Surgery·John A HarvinJohn B Holcomb
Nov 26, 2013·The British Journal of Surgery·D G WeberZ J Balogh
Apr 5, 2016·Military Medical Research·Yu-Hua Huang, You-Sheng Li
Jan 22, 2015·Journal of Veterinary Emergency and Critical Care·Nathan W PetersonJames W Barr
Mar 4, 2014·The Journal of Surgical Research·Bellal JosephPeter Rhee
Jun 21, 2016·Journal of the American College of Surgeons·Derek J RobertsUNKNOWN Indications for Trauma Damage Control Surgery International Study Group
Aug 30, 2016·Current Problems in Surgery·Julie L HolihanTien C Ko
Jun 21, 2012·Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition·Randall S Friese
May 28, 2016·Annals of Surgery·Derek J RobertsHenry T Stelfox
Feb 23, 2017·The Journal of Trauma and Acute Care Surgery·Justin Jeremiah Joseph WatsonMartin A Schreiber
Apr 17, 2018·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Kapil GuptaJoseph Arnold Fisher
Jun 18, 2019·The Journal of Trauma and Acute Care Surgery·Jack SavaKenji Inaba
Sep 25, 2014·The Journal of Trauma and Acute Care Surgery·Stephanie A SavageBen L Zarzaur
Apr 12, 2012·The Journal of Trauma and Acute Care Surgery·Matthew J MartinJohn Holcomb
Oct 17, 2017·Current Opinion in Critical Care·Daniel Benz, Zsolt J Balogh
Jun 12, 2013·Revista do Colégio Brasileiro de Cirurgiões·Rodrigo Camargo Leão EdelmuthMarcelo Augusto Fontenelle Ribeiro
Sep 17, 2020·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Akira EndoNoriaki Takiguchi
Apr 22, 2017·The Journal of Trauma and Acute Care Surgery·Miguel A VillalobosMark J Seamon
Jul 8, 2015·The Journal of Trauma and Acute Care Surgery·Derek J RobertsHenry T Stelfox
Apr 19, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Bogdan DiaconescuMircea Beuran
Dec 22, 2019·The Journal of Surgical Research·Derek J RobertsJohn A Harvin
Oct 16, 2021·World Journal of Emergency Surgery : WJES·Derek J RobertsHenry T Stelfox

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