Damage Control Surgery

Damage control is the process of counteracting an unfavorable situation in order to curtail losses. First utilized by the United States Navy, a “damage controlman” was responsible for temporary salvage of a vessel under duress so that it could make its way to a port for formal repairs. This principle, rapid salvage to stabilize long enough for definitive repair, was adopted by numerous surgical fields and is now considered the gold standard in the care of significantly injured patients. This concept encompasses the entirety of patient care from the point of injury and initial resuscitation to the control of hemorrhage and contamination to stabilization in the critical care unit and back to the operating room for definitive anatomic repair. In this chapter, we will review the history of damage control, provide a guide to damage control procedures with specific focus on blast injuries, and reinforce the necessity of proper damage control resuscitation in concert with the surgical interventions.