Surgical Damage Control and Temporary Vascular Shunts

Daniel J. Scott*, Todd E. Rasmussen

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review

2 Scopus citations

Abstract

The past 30 years has witnessed a fundamental change in the approach to the multiply-injured patient. With increasing enthusiasm for the dogma of damage control surgery, surgical strategies to quickly stabilize a severely injured patient have focused on methods of vascular control and on cessation of hemorrhage-the latter often meaning a default to vascular ligation if simple, quick repairs are not feasible. Use of a temporary vascular shunt to expeditiously restore perfusion in the setting of a significant axial vessel injury, however, has now become an accepted alternative to ligation. While vascular shunts are not novel concepts, their use has become greatly encouraged by experience afforded by the wars in Afghanistan and Iraq. Promising outcomes in the management of complex extremity vascular injury have also been echoed in the civilian literature where the necessity of shunt use is driven by the damage control imperative rather than the need to transport patients to a higher level of care. Some surgeons have expanded use of these adjuncts to the management of truncal vascular injuries where ligation often carries significant morbidity and mortality in an already-threatened patient. As such, the intraluminal vascular shunt is a valuable concept that provides surgeons with a much-needed solution to the perpetual dilemma of whether to repair or to ligate a major vascular injury.

Original languageEnglish
Title of host publicationRich's Vascular Trauma
PublisherElsevier Inc.
Pages198-205
Number of pages8
ISBN (Electronic)9780323315050
ISBN (Print)9781455712618
DOIs
StatePublished - 1 Jan 2015
Externally publishedYes

Keywords

  • Blood vessel
  • Damage control surgery
  • Extremity vascular injury
  • Injury
  • Ligation
  • Shunt
  • Temporary vascular control
  • Trauma
  • Truncal vascular injury
  • Vascular

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