J.Jpn. Surg. Soc.. 103(7): 500-502, 2002

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Feature topic

DAMAGE CONTROL SURGERY-A HISTORICAL VIEW

“Damage control surgery" is a surgical strategy to cope with the lethal triad of death, i.e., acidosis, hypothermia, and coagulopathy, often seen in severely injured patients. Perihepatic packing was attempted by some trauma surgeons during the 1970s as an alternative to hepatectomy for severe liver injury, with favorable results. The concept of bail-out surgery and reoperation was introduced during the 1980s as a treatment rnodality for severe abdominal trauma. This strategy of trauma care was named “damage control surgery" by Rotondo et al in 1993, which consists of initial laparotomy, secondary resuscitation, and definitive surgery. Angiography and TAE may be used during secondary resuscitation for hemostasis. The concept of damage control surgery is now applied not only to severely injured patients but also for other surgical patients in critical condition. Damage control surgery was introduced to Japan during the late 1990s. However, the Japanese experience has been limited because the volume of severe trauma cases is very small.

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