Question
Which of the following is the correct sequence of steps in damage control surgery?
| A. | Identify the patient → ICU resuscitation → Control of hemorrhage → Abdomen closure |
| B. |
Identify the patient → Control of hemorrhage → ICU resuscitation → Abdomen closure |
| C. |
Identify the patient → Control of hemorrhage → Abdomen closure → ICU resuscitation |
| D. |
Identify the patient → Abdomen closure → Control of hemorrhage → ICU resuscitation |
|
Correct Answer » C Explanation |
 |
Damage Control Surgery (DCS)
Damage Control Surgery is a staged approach used in critically injured trauma patients who are at risk of the lethal triad:
- Hypothermia
- Acidosis
- Coagulopathy
The aim is to perform only the essential life-saving procedures initially and defer definitive repair until physiological stabilization.
Correct Sequence
Step 1: Identify the Patient
Patients suitable for DCS include those with:
- Severe trauma
- Massive hemorrhage
- Coagulopathy
- Acidosis
- Hypothermia
- Hemodynamic instability
Step 2: Control Hemorrhage and Contamination
Abbreviated surgery is performed to:
- Control bleeding
- Control gastrointestinal contamination
- Avoid lengthy definitive procedures
Examples:
- Packing
- Vessel ligation
- Temporary vascular shunts
Step 3: Temporary Abdominal Closure
The abdomen is temporarily closed using:
- Bogota bag
- Vacuum-assisted closure (VAC)
- Temporary mesh closure
This prevents:
- Abdominal compartment syndrome
- Heat loss
- Fluid loss
Step 4: ICU Resuscitation
The patient is transferred to the ICU for correction of:
- Hypothermia
- Acidosis
- Coagulopathy
This phase includes:
- Blood products
- Ventilatory support
- Hemodynamic optimization
Step 5 (Not Included in Options)
Definitive surgery and formal abdominal closure are performed 24–48 hours later after stabilization.