Damage Control Surgery for Non-Trauma Patients: Severe Peritonitis Management

Excerpt

Damage control surgery is yet to find its indications for non-trauma patients [1]. The spectrum of pathologies that potentially could be managed by acute care general surgeons along these principles includes septic, haemorrhagic, ischaemic and a combination of these conditions. The beginning of the physiological derangement in acute general surgical conditions is less well defined and more often involves postoperative complications, multiple comorbidities and malignancy. Unlike in major trauma, up until recently acute general surgical patients were not characterised by universally accepted anatomical and physiological descriptors allowing comparisons among different clinical series. Physiological parameters are essential to define the indications for trauma patients entering into damage control surgery mode involving an abbreviated surgical procedure, restoration of physiology and definitive surgical repair when the patient’s homeostasis is sound. …