Phase 2 of Damage control surgery occurs at
Deadly triad of trauma Following a trauma protracted surgery in physiologically unstable patient, the three factors that carry moality are Hypothermia Acidosis Coagulopathy Hence originated a phenomenon - DAMAGE CONTROL SURGERY Phases of damage control surgery Phase1 :Initial exploration Phase 2: Secondary Resucitation Phase 3: Definitive operation Phase 1(initial exploration) Control of active hemorrhage and contamination Midline incision--4 quadrant packing done GIT perforation done with sutures or staples External drains kept for pancreatic or bile duct injuries Temporary closure of abdomen using plastic sheet known as OPSITE This technique of closure is known as VACPAC or OPSITE SANDWICH Phase 2( secondary resuscitation) Transfer to ICU Ventilatory suppo Correct the deadly triad Hypothermia, acidosis, Coagulopathy Phase 3(definitive treatment) Planned re exploration and definitive surgery Done 48-72 hrs after secondary phase Complex reconstruction must be avoided Ref : Bailey and love 27th edition Pgno: 318-326, 378-380, 426
Pre hospital management
Resuscitation in ICU
Resuscitation in operating room
Definitive repair
General anatomy